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lets talk about PROM

post #1 of 43
Thread Starter 
I found this from an old thread on here... this is pamamidwifes words...

Pre-Labor (or Prolonged) Rupture of Membranes

Any rupture of the membranes (water bag) constitutes the general distinction of ?labor?. While you may or may not be contracting, the simple fact that your membranes are ruptured dictates a change in daily hygiene routine and supplementation. The bag of water provides more than a cushion for baby ? it also serves as a barrier from bacteria and infection. Prelabor (meaning no uterine contractions present) rupture of membranes occurs in about 6-19% of all term pregnancies. Epidemiological data shows that about 86% of all women with prelabor rupture of membranes go into spontaneous (not induced) labor within 24 hours of their water breaking. Only 6% of the remaining go longer than 96 hours without any sign of labor starting.

Some membranes rupture high up in the uterus. This is called a ?hind leak?. Typically, water will come out slowly, perhaps gush once and trickle here and there. Hind leaks may be caused from baby?s foot breaking the bag, or a positional change. As there are two layers of the membranes (the amnion and the chorion), sometimes leaking may be caused from the outer layer of the bag (the chorion) breaking. In both cases with a hind leak and a leak from the chorion breaking, there is a good chance of the bag ?resealing? itself with cessation of any sort of leak.

A ?full leak? is a break in the lower part of the uterus, particularly over the cervix. This sort of leak rarely re-seals. While it may be difficult to know what type of rupture has occurred, the following guidelines should be followed any time there is suspicion or confirmation of a rupture.

Currently, the medical literature shows that expectant management (waiting until labor starts with the following guidelines) is an effective and safe course of action, provided NO VAGINAL EXAMS ARE DONE. Of course, you do have the right to choose to be induced in the hospital at any point during this prelabor period. However, by being in your own home, you already are much more protected from bacterial infection than if you were in a hospital (the overall infection rate is four times higher in a hospital, hence the need for more rigorous antibiotic regimes). The bacteria present in your home are bacteria that your body is familiar with and acclimated to.

? Absolutely, positively, NOTHING in the vagina. No fingers, tampons, penis, oral-genital contact, etc.

? Drink plenty of water to help replenish amniotic fluid ? at least 64oz of water a day

? Wear something loose-fitting with no panties when you can

? If you are leaking and need something for sitting, use clean towels fresh out of a hot dryer

? Take your temperature every 4 hours while you are awake (record on a sheet of paper).

? Take 250mg Vitamin C every 3-4 hours while you are awake

? Eat foods that are unconstipating and easy to digest

? Be meticulous about toileting (wipe front to back, clean toilet tissue, etc.)

? After showers, use a clean towel fresh out of a hot dryer or oven to dry your vulva

? Do fetal movement counts twice a day after eating (looking for 10 movements in an hour)

? Notice any change (color, odor) to the fluid and report results to your midwife immediately

? After a full 24 hours since rupture, the addition of Oregon Grape Root and Echinacea tinctures to your daily supplementation regimen is recommended. Take a dropperful of each tincture four times a day.

post #2 of 43
post #3 of 43
I had a "leak" at 31 or 32 weeks. I was previously informed in my last pregnancy before this one that it was okay to wear panties but to change the pad frequently and change your panties frequently throughout the day. I just layed on the couch and drank lots of water and it resealed by the end of the next day. Thank goodness!
post #4 of 43
Ahhh, this is a sweet spot topic of mine. I got a lot of flack and a TON of support during my 3rd pregnancy when my water broke at 31/32 weeks and I chose care at home instead of going to the ER. I would stay home a 1,000 times over having all behind me.

Here's my story...
My 3rd pregnancy was a rough ride for me (and probably babe, too!). I had Hyperemsis and was very sick. It was the first time I'd ever been admitted to a hospital except when I was born. I continued to vomit all through my pregnancy. One night after a particularly pukey day at 31/32 weeks, I stood up from the couch to go to bed & water gushed down my legs & onto the floor. I was shocked.

The first thing I did was I called a MW that we'd worked with before. She told me everything she knew about how to handle the PROM & then in the next hour when pre-term labor started, we called her again. We did pretty much everything that Pamamidwife recommended in the OP.

This is what worked for me.
- Wine for ctx. I drank a small glass every few hours until the ctx were gone and then whenever needed after that.
- Inversion. My DH propped one end of the couch up with 6 inches worth of books under the legs.
- Bed/Couch rest for the first week.
- Raw nuts to encourage testosterone
- Lots of water with lemon.
- Herbal Tinctures: Wild Yam Root, False Unicorn & Red Raspberry Leaf
- Vitamin C, a ton of it ever few hours. (this was immediately to reseal the bags. It's been that long for you, they might not reseal. But, either way, it'll ward off infection.)
- Probiotics (yogurt, acidophilus, bifidolphilus)
- Homeopathics, Ruta & Arnica
- Bed rest (I did this for the 1st week and then very modified from then on)
- Decision to get steriod shot for lung maturation - We couldn't find anyone to give this to me without me going to the hospital. We opted not.
- Avoid Soy and any other estrogen rich foods.
- Nothing in vagina (finger, penis, etc)
- No baths, hot tubs or swimming pools
- Taking temp
- Watching for movement

My bags of water ended up resealing & refilling. I ended up birthing my baby at 41.5 weeks & she was pink & so healthy! She had plenty of water & I was so thankful that we were able to tune inward to do what was best for her.

post #5 of 43
awesome story!
post #6 of 43
My water likes to break at 35 weeks, no one knows why. I have been in that 6% to not go into labor on my own. WIth #3 I was kept in hospital for a week until I hit 36 weeks and demanded to be induced.

#4, I was novernight and them told them I was leaving and wanted oral antibiotics(as opposed to continuous IV. They complied and 36ish hours after my water broke I was in labour. I think the fact I could go home and relax in my own surrounding, sleep in my own bed etc is what helped me go into labour instead of sitting around until 36 weeks again.

The above story is amazing, personally I know that waiting for an extra 10 weeks with my water broken would drive me insane. I already dealt with lots of infections this last pregnancy so wouldn't risk it but I am in awe, it gives me home for #5 that if my water breaks at 35 weeks again I don't necessarily have to have another prem baby.
post #7 of 43
Originally Posted by swellmomma View Post
The above story is amazing, personally I know that waiting for an extra 10 weeks with my water broken would drive me insane. I already dealt with lots of infections this last pregnancy so wouldn't risk it but I am in awe, it gives me home for #5 that if my water breaks at 35 weeks again I don't necessarily have to have another prem baby.
I'm sorry you've experienced this so much.

I think the real key was immediate action to reseal the bags. I didn't have broken water for 10 weeks. Within a couple of days I stopped dribbling. And, I was not showing any signs of infection. My bags refilled over the next week as well.

I really think the way that hospital's treats PROM encourages premature birth and infections, plus we all know germs/bacteria/viruses in our own homes are much safer for us than what's in the hospital. The CDC reported May 30th of this year, "In American hospitals alone, healthcare-associated infections account for an estimated 1.7 million infections and 99,000 associated deaths each year." http://www.cdc.gov/ncidod/dhqp/hai.html

You're absolutely right, if your water breaks with #5, you DO NOT have to have another premature baby or an infection. You absolutely don't have to.

Oh, I should address, that while I didn't necessarily WANT to almost go to 42 weeks (my other babes came at 38 weeks), I was just so pleased that I had created an environment for birth that trusted my body to gestate & birth my baby when it was totally ready. Having gone through PROM and needing to tune inward to find the best path for my baby, I was very tuned in the rest of my pregnancy. I knew everything was fine & my baby just needed some catch up time. I was tuned in enough to know that she would come in her own time when it was for the highest good. I really believe my body rewarded me with a quick & relatively painless 1 hour, 40 minute labor.
post #8 of 43
This is what I am trying to do. Create an environment here at home that is relaxing and condusive to birthing so that baby can be fine even if my water does break early again. (I really think my OB accidentally stripped too much the last time she did it with DD). And I am refusing all internal exams at this point. I am more educated this time around to prevent an early baby and any long hospital stay. (I stayed 5 days with both of my previous kids for one reason or another. I was going CRAZY in there!) I am hoping that drinking the RRL tea will help me labor at home where I can handle it since I won't be having epidurals this time around!
post #9 of 43
Thread Starter 
here's a website that has a lot of information on PROM from a 'natural' perspective...


some gems..

... PROM is when the membranes rupture before labor begins. Unfortunately, most doctors still make no distinction between true PROM and a leak.

pelvic examinations during the last three months of pregnancy have been shown to contribute to the incidence of PROM ..

...When a woman's amniotic sac suddenly ruptures, there is a real danger that the cord might be swept out with the fluid. However, doctors do not recognize that such an occurrence is very unlikely if the woman merely has a leak.

...the maternal complication of most concern with PROM is chorioamnionitis, or inflammation of the fetal membranes... the incidence of chorioamnionitis in the general obstetrical population is 0.5-1%; but it is 26-28% in women with a latency period (time between PROM and onset of labor) of 24 hours or more.

Because of the high risk of infection in the hospital, doctors have tried to counteract it with antibiotic treatment while the woman is still pregnant. In a study conducted by Owen, Groome and Hauth on 117 women, half of whom received antibiotic treatment and half who did not, they found antibiotic treatment after PROM to benefit the mothers, but not the infants.
post #10 of 43
One of the rare occasions when I'll say anything good about hospitals, but my local has FINALLY stopped treating PROM as a high risk situation. I think the medical tide may finally be turning.

Spark, thankyou for sharing your full regime of what you did. EVERY time I want to complain about the baby being low at this point, I remember the panic I felt when your waters went I can't imagine what you must have been through.
post #11 of 43
Thank you for this thread! I'm not a UCer (I hope its ok that I'm in here!), but the topic caught my eye as I was browsing.

Just out of curiousity, would you take the same route with a pre-viability pPROM? My water broke at 20 weeks with ds, we think b/c of heavy 1st and 2nd trimester bleeding, but we can't be sure.

I got the full round of hospital care, including IV abx, oral abx, several rounds of steriods, weekly u/s, and a 2.5 month hospital stay. Ds was born at 30 weeks when the placenta began abrupting.

I am hoping to avoid all this stuff in my next pregnancy, including the pPROM.
post #12 of 43
Thread Starter 
liberal chick~ sorry to hear you went through all of that. But you have your baby now, that's the important thing. I would think that these same ideas to not get an infection are appropriate for earlier as well.

I think vitamin E and C helps to create a thick sac as well.

Just eat really well before during and after pregnancy. Make sure you get lots and lots of fresh veggies and fruit, the protein that you digest best, lots of good water (spring, reverse-osmosis...etc)

The sac is made out of collagen, and the more foods that help produce collagen you get from your diet the better it will repair, or not rupture at all. ie, raw veggies and fruits

I also found this on copper depletion/collagen connection
post #13 of 43
I had SPROM with my second kiddo.. Sudden Premature Rupture Of Membranes.... My waters broke at 27 weeks.. He was born not even 12 hours later... I was already dilated to 3-4 when they broke..
post #14 of 43
Thread Starter 
That must have been hard for you!! Do you know why you went into labour so early?
post #15 of 43
Me? I have an incompetent cervix.. As long as I dont labour early this time Ill get the birth I want (UC)
post #16 of 43
wow, I have a very similar story to Spark. I had pPROM at 30.5 weeks. I was very medicalized at this point in my life. I had been having constant contractions since about 26 weeks, had an appt, got sent to L&D to be monitored and I felt a leak after I peed in a cup for them. They did a fearning test (which I really don't trust for some reason). First test was inconclusive, second test was kind of positive, third test was very positive. Since my hospital didn't have a NICU, I was shipped to another hospital. After 24 hours at the other hospital, I was sent home because they couldn't find a leak. I stayed off work till 35 weeks, then went back full time till she was born at 39w, 5d.

I had no idea what to do in that situation. i love all this info I am finding here. Now, if it happens next time, I know what to do. Better yet, I know what I need in my diet to PREVENT it from happening again. I am not yet TTC, but I am currently planning at least a HB, possible a UC for next time.
post #17 of 43
Bumping for a mama who needs it...
post #18 of 43
post #19 of 43
Man, I wish this thread had existed two weeks ago.
post #20 of 43
Thread Starter 
Originally Posted by joliara View Post
Man, I wish this thread had existed two weeks ago.
I know!! I saw the need after you went in to the hospy. I really wish it was somewhere on here before too! There have been numerous women w/ PROm and not much info about it here.

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