This was our second twin pregnancy
after a previous PPROM loss at 19
weeks and a result of our fourth IVF
transfer. Because of my previous loss,
I had a cerclage placed at 13 weeks
and was on bedrest at home from that
point forward. I also had weekly
cervical checks, which went well until
I hit 25 weeks.
At that appointment, I was told that I
was 1 cm dilated and 50% effaced, and
the OB wanted me to go to labor &
delivery for monitoring. Once there,
we found that I was having some
uterine irritability and mild
contractions, but nothing that was too
alarming. The OB was ready to send me
home, but my perinatologist wanted to
keep me overnight. Good thing, because
my water broke later that night. I was
officially confined to bed for the
remainder of my pregnancy.
We already knew we were having two
girls, which I was told over and over
played in their favor. They gave me a
series of steroid injections to help
mature the babies' lungs, put me on
magnesium sulfate to prevent labor and
antibiotics to ward off infection, and
sent a neonatologist to talk to me. He
said my babies would have about an 80%
chance of survival if they were born
immediately, and every healthy day in
utero made their chances greater. If
they survived the first 4 or 5 days,
their odds would go up to the high
90s.
We managed to hold off labor for one
week. A point of contention among the
many great doctors caring for me was
the cerclage. Leave it in and risk
infection, or take it out and risk
instant dilation and a sudden vaginal
delivery? It turned out to be a moot
point, as I spontaneously went into
labor the day before the cerclage was
to come out.
An ultrasound was performed and we
found that the babies were transverse,
lying one on top of the other. To
minimize the trauma to the girls, the
OB decided to do an emergency C-
section with a vertical incision
instead of the usual bikini line
incision. I was wheeled into the high-
risk delivery room at 6:15, and my
daughters were born about 45 minutes
later. Olivia Renee was born at 7:02
pm, 1 lb 15 oz and 14 inches long.
Cassandra Faith was born at 7:03 pm, 1
lb 12 oz and 13.5 inches long. They
were both whisked off to the NICU,
where their little lives hung in the
balance for most of the first month.
It turned out that I had contracted an
E. coli infection despite the
antibiotics, and Olivia (the twin with
the ruptured sac) was very sick.
Our story has a happy ending, though.
Cassie came home after 98 days in the
NICU, one day before their official
due date, and Olivia followed two
weeks later after 112 NICU days. So
far, it looks like they may both
escape some of the most serious
consequences of extreme prematurity,
although we won't know for a long
time. They are now four months old
(one month adjusted) and doing great
at home!
Paula's PROM
Story
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