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Making it to term after a 20 wk pPROM

post #1 of 8
Thread Starter 
I wasn't sure where I post this question. I usually visit the UC board, and HB didn't seem appropriate. I asked in the loss forum since there is always this risk after having pPROM, I assume. I also wanted to ask the pros what they have observed.

This is my situation; I had a high leak at just before 20 weeks, on Monday PM. I am SURE it was, and I also had low back ache and a some CTX. I was keeping hydrated, but couldn't really do a full bedrest. I would call the CTX BH, since this is #8 and many have them that early having so many children, so that info may be insignificant. I also shared on the loss and UC board about how we lost another twin during this PG at 10.5 wks. Lost a twin last PG too at 6wks. I also had the full spotting for 5 wks this time, and I am SURE this wasn't a leak from that twin, as the other baby was fully absorbed by our U/S a couple days later. Plus, when I M/C that baby, it was dark pink waters, and LOTS of it, so I am sure the amnio fluid came out then.

The baby we have is looking good, fluid levels were fine, and SHE is a GIRL! Woohoo! The leak seems to have sealed up, or it is so minor at this point, that I cannot distinguish it from slightly wetting myself. I had this incontinence start quite early, OR I never was wetting on myself at all and it was a VERY tiny amount of AF the whole time. It is back to MY normal now though. And, I don't seem to be wetting on myself as much if at all, and the only wetness I am having is clear, watery, and really doesn't smell like urine, could be just normal vag D/C. So, I can't be 100% sure it isn't amnio waters, but it is VERY little. And, my CNM MW didn't seem all that concerned when we were talking after the U/S. She was extremely busy too, and knows that I would tell them if I was concerned. Actually, I think if I was concerned, they would get that way fast, since I don't tend to panic easily. I see many things as just a variation as normal.

So, anyway, to my question. I am usually a 43 weeker mom. I was actually 15 days late with the last baby with the lost twin. I would expect the same with this one. But, how likely is it that I will go to term even after having a pPROM?

At first, I didn't think it was likely I could even have a PROM/high leak at 20 weeks. But, I was assured that it is possible, and sounded very much like a leak, after the ladies read what I relayed to them. I filled 9 pantiliners in a couple hours and messed up 3 pr of underwear. Used a size 4 diaper overnight, and filled a diaper on Tues AM by noon, but not soaked, just obviously very wet, back to 2-3 liners after that a day). I had been using only 1-2 pantiliners for what I thought was incontinence before this. And, am still using 2-3 a day now.

Since it was realized on Tues, and my U/S and dr appt was Thurs, I wasn't overlly concerned. Nor is there really much that can be done, since the baby isn't viable. OTOH, if I thought bedrest would help, I would have done it. It was advised, but now I have read that it doesn't help, and puts a woman at risk for blood clots in the legs and lungs. I already have that (small) risk, but the CNM insisted on a baby aspirin a day last month, so I really do have to keep moving. I also have 7 other children. So, now that VBS is over (and I skipped out last night), I am going to just try to stay at home and take it easy until I can be SURE that it has resealed.

I haven't had much luck on getting stats for how many with pPROM make it to term, just about prelabor and making it to term is 50%. I am not having labor, nor was I, unless you count the terrible low back ache, but it wasn't the whole time. So, any ideas? Kymberli
post #2 of 8
I'm not a birth professional, but I'm a preemie mom. I know you say you aren't having labor, just a back ache, but I'd like to point out that preterm labor can feel quite different from full term labor. If you are having any other symptoms, contractions, bleeding, pain, fever, I think you should call your MW and create a plan for handling the rest of your pregnancy. I hope everything works out well for you and the baby!
post #3 of 8
Thread Starter 
Thank you so much for your reply. I realize you are right. Back ache, even at 8 mos (ex-mil had on this on a preemie), can mean labor. That has mostly gone away. Last night, I did have lower down ctx in my uterus, but it is so common with being pg with #8, so it is hard to decide WHAT is going on. And, so I drank a quart of ice water, and it seems to have subsided for today. Now, I have a killer headache. I don't think I have fever. I feel fine otherwise, just the headache. But, I also haven't taken my baby aspirin the last two nights, because I lost it. But, I have never been on them before this PG, when it was advised by my MW to go on it.

So, I had already put myself on bedrest at home since Fri PM, and making my kids and Dh comply. I am not sure that the leak has fully stopped, but seems it could be. However, with the ctx, that disturbs me, so I am drinking JUST water now. I don't like water, so this was a difficult step for me.

I will reevaluate things by Monday. If anything seems alarming or my instincts start ringing, I will call the midwife. She really didn't seem concerned, although she did agree with me that it probably wasn't peeing on myself. The U/S tech said the fluid levels were good, but I am not too sure about them. As they couldn't tell me during the first U/S that it was surely a lost twin. They had to have someone else look at the pics to say so. Kymberli
post #4 of 8
I was advized to do a baby asprin therary for my pregnancy by my fertility Dr, but after farther research chose not to for many preasons. I do know that it is something you should stop by 36 weeks, earlier if you are likely to have your baby earlier. So you may want to talk to your midwife about reevaluating the baby asprin....

I'll say a prayer for you and the baby. I hope your leak reseals and that you go on to have a healthy term aby. I don't know of anyone professionally who has went to term after something like this, but anecdotally I know it happens.
post #5 of 8
I had pPROM at 20 weeks with my first son in 2005. In my case, I had gushing fluids (pPROM occured at night, my AFI the next morning was 4.5, so visibly decreased), so we knew it was a rupture. Eventually, though, I started doing what you are describing: just leaking a little. However, when I was 27 weeks I began gushing fluid again. Our theory was that ds has somehow lodged himself into the hole, but then eventually moved.

Anyway, I did go on full hospital bedrest. I was allowed to get up to use the restroom and to shower once daily, but other than that I was in the bed. I also drank a ton of water.

When I was 30 weeks I began having some bleeding and it turns out the placenta was abrupting, so I went in for a c-section (ds had been locked into a breech position). His legs were underdeveloped from lack of use (for lack of a better term) and his lungs had a really hard time at first, but after that it was relatively smooth sailing. He spent 7 weeks in the NICU.

And, just a sidenote, the doctors at the hospital told me that they didn't advise me to continue the pregnancy after 34 weeks. At that point they said the risk of a cord accident was greater than the risk of prematurity.

Thinking of you...
post #6 of 8
My waters gushed at 30 weeks and 12 weeks later my healthy plump baby was born. I took IMMEDIATE action when it gushed though. I listed everything I did in this mondo thread on the subject. A good friend of mine used the same protocol when hers gushed at 16 weeks... and her baby went overdue, too!

http://www.mothering.com/discussions...ight=prom+wine

Wishing you a beautiful healthy baby born in another 20 weeks!
post #7 of 8
Thread Starter 

pPROM to PIH?? What the....?

Thank you ladies so much!! I have read a lot of positive stories, so that is good. There are some sad ones too, and I am so sorry for those families.

I did go to the ER last night. I had thought I was still leaking some, and had a migraine ALL DAY that I couldn't kick with any of my bag of tricks; upping protein, drinking only water, bedrest, etc. I also took Vit C and cranberry (in case of UTI), and my RRL tea. But, then I decided I needed to stop the tea since the day before I had a lot of CTX and low back ache.

The ER doc said the migraine was probably not from anything. It was gone by the time I got there though, but my BP was 153/96!! And, he took it twice. Yikes! They both said I didn't look Pre-e, and dehydration can cause headaches. Migraines can cause HBP. Then the OB nurse said that I was neg for amnio fluid, but I was still more moist than I should have been. I told her about Mon, and she tried to reason that away too; too much fluid for the baby to replace by Thurs AM, it could be vaginosis and leuk-whatever it is. Uhhh, no. I don't have a yeast infection, and even when I have, it was never watery without odor or sweetish. But, perhaps it has sealed, and this is just a wet pregnancy at this point. So, that is good news. The OB nurse took my BP again, and it was still 136/86, which is really high for me. She did my reflexes and looked at my feet, of course. But, never mentioned the BP was an issue the MW might want to see me for. She said make a newer appt with the MW to possibly test for vaginosis, or whatever was causing the dripping. If all was well, why??

So, I called the MW today, and talked to the nurse, that I didn't see any reason to come in. The baby was moving alot, her HR was really good, and I had just seen her on Thurs. I told her the story, except the HBP, but that was because I forgot. I picked up some protein powder today, because I know that is the only way I can get more in me. And, I will drink more, and watch out for headaches again. I have also had one part of my eye be blurry before, but I have also had a lot of allergies lately. I have also had these migraines before, and I thought it was too soon for pre-e. The ER dr says it isn't, but he didn't think that was starting, nor did anyone think I had any infection. So, that was good news.

This PG, I have really felt like crap after I have been cleaning, standing, going to do errands, etc. This is the SAME way I felt with my first PG when I did get pre-e. So, that does make me wonder, but my BP had always been good. 95/55 when not PG, 110/65 since this PG at 11 wks. I didn't know at that time, that it was a diet issue. But, I have to be careful to not have too many carbs and plenty of protein anyway, since I am really hypoglycemic. But, I haven't been doing too great lately, hence the protein powder. DS likes to use that too, so I am sharing. I know natural protein would be better, but this is actually a cheaper way to get that many grams, and I am not a big meat eater.

So, I hope this doesn't turn into a high risk situation just because of HBP, because I know that is serious for both of us. Many times, protein helps, but sometimes it doesn't. This PG has been sooo weird. Kymberli
post #8 of 8
I hope everything smooths out for you soon. I have also been dealing with the HBP already, and mild signs of pre-e for a few weeks, so, it is not too early.

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