PPROM Update - Birth Story (kinda positive!)

mrexpress

New member
Unicorn PPROM Story, 28w to 36w induction for vaginal breech birth ended in c-section and NICU stay (water breaking early and staying pregnant afterwards)

Hello!

I was looking all over for PPROM stories (water breaking early) when it first happened to me, so now I’m going to share my experience, but because my experience is a bit of a unicorn. Mine is a story that I hoped for and didn’t see too many stories reflecting the smaller statistics so I’m here for that!

TL;DR: got dehydrated, ended up with contractions that the L&D monitor didn’t pick up due to misplacement on the part of the nurse, couple of days later water broke in a trickle at 28 weeks, it was a very stressful time but baby and I beat the odds and he stayed in for 8 weeks as I lived inpatient at the hospital. I have a daughter and being away missing that time with her was the hardest part, second hardest part was worrying about my baby boy. My vaginal breech birth induction was at 35w6d and labor lasted 12 hours when suddenly my baby had heart decelerations indicated he was stressed. He also wasn’t descending into the birth canal, in fact he was stuck. I consented to a c-section after failure to progress and that was the single most terrified I’ve ever been in my entire life. When they pulled him out, he had been stuck under my rib and my uterus made a “horn” to accommodate his head. Half his brain was smushed down, it was a scary sight. It was a high leak in the sac because the rest of the sac was intact and he inhaled fluid and my blood, which caused him to end up with bilateral pneumothoraxes, collapsed lungs and pneumonia so he was in the NICU for 15 days. He’s 4 months old and doing great! Rolls over both ways. Giggles. Babbles. Plays. Sleeps through the night. Happy baby! I had a touch of postpartum depression and extreme difficulty bonding to him for a couple weeks, but I’m all good now. I also exclusively pump and have an oversupply like I did last time with my daughter. I’m grateful for all the lucky things because this story could’ve gone so much worse and so much of it has to do with luck.

——— the story with details and the lead-up

27 weeks: we have a garage sale and a homeowner’s association party afterwards and I get super dehydrated and start getting painful “Braxton Hicks” contractions that go through the entire night, so I think they’re just round ligament pain or normal overexertion pain. I was bent over on the couch in cat pose because of the pain. My husband made a comment saying he doesn’t remember me being in so much pain with our daughter at any point other than labor. I began to time them the next day and into the evening since they won’t stop. They’re coming every 5 min for 1 min. I call my OB and am told to go to L&D.

I get to L&D and they are full so I wait for 2 hours. Contractions continue on schedule.

Get to being monitored and the nurse puts the monitor for contractions WAY too high on me and I tell her it’s too high, the contractions are wrapping around my back and coming to the front and the monitor needs to be lower. She tells me the contractions begin at the fundus (top of uterus) and shut me down. In hindsight? I wish I had known I could move the monitor probe down where I knew it would pick up what was happening. MOVE THE MONITOR WHERE YOU FEEL THEM DO NOT LET A NURSE TELL YOU THAT YOU ARE WRONG!

Everything looked good to the team, so they sent me home telling me it’s powerful round ligament pain. I argued with them and said there’s no way because it isn’t pain isolated to those ligaments but they shuffled me on my way. Such a bad decision.

I took hot baths and eventually they calmed down more. The entrance to my vagina felt itchy and I wanted a test for BV.

Went to my pre-scheduled OB appointment the next day but a hurricane was coming so they couldn’t do any labs or ultrasounds. OB shrugged and said that round ligament pain can be much worse in second+ pregnancies.

By the next day, I took my daughter to school (the day before the hurricane was going to come our way) and when I got home, I got a case of the shivers, just like when I was labor with my daughter. It was weird.
It took 2 entire hours, 5 baths full of hot water then a shower filling a bath before I stopped shivering.

28 weeks: next day after that shivering episode, I hit 28 weeks 1 day. I took my daughter to play with the son of one of my best friends. Hung out there all day and came back around 6 pm. Took a shower. Laid in bed. Got up to go pee and some fluid gushed out of my vagina and I immediately thought that was strange. I tried smelling but it didn’t smell like much of anything. Laid back down for 40 min then got up to pee again, fluid gushed out into the toilet before I began to pee and that’s when I knew. Laid back down for 20 min. Used my hand to reach back and spread my labia. My hand got soaked with water. I ran to the bathroom and stuck a cup under me and caught about a tablespoon of blood-tinged water.

Called my OB and went to L&D. They couldn’t get positive Amnisure (amniotic fluid swabs) and even though I brought the fluid I caught, the blood in the fluid can cause wrong results. Since this only occurs in 2% of pregnancies + I stopped gushing, they almost sent me home until I asked for an ultrasound. They did one and my fluid (AFI) was 6.11. It shouldn’t have been so low, should’ve been 20+. So, I was immediately admitted into the hospital under suspicion of PPROM.
Preterm Premature Rupture of Membranes.

In hospital
I stayed in the hospital for two months, a little over 8.5 weeks. It was like being in a nice jail with good food. I am extremely blessed that the hospital I was at was 5 minutes from my house, ranked #1 in the state, had a level 4 NICU, had awesome food for room service, etc. Amazing hospital. Only downside was that if I wanted to go outside I would’ve had to ask a nurse to wheel me out to the parking lot. So I never went back outside the entire time I was there.

When they decided to admit me for PPROM, they were dedicated to proving it was PPROM. Because even though I was claiming I gushed fluid, they couldn’t get a positive test for the fluid so it could be, in their minds, an issue with the baby or an issue with the placenta. I had four ultrasounds over the course of a few days. The fluid levels went up and down between 2-7 cm AFI.

At the fourth ultrasound, they wheeled me to the MFM office so they could use the very big and fancy ultrasound machines. The fluid was at a 4. Baby doing great. Placenta doing great. They told me despite having no positive fluid test, they were diagnosing me with PPROM based on my clinical presentation (the story I told above of how I felt all the fluid after having days of painful contractions + the fluid being so low and variable).

Later on, I started gushing fluid again and they did get a positive test.

The first week was one of the hardest emotional times in my life. I had constant panic attacks and cried my ass off. Even though I was so lucky to have my husband be able to bring our daughter to have family dinner every single night, some nights I actually couldn’t emotionally even handle being around them. I would go majority of a day without feeling my baby move at all because he was so stuck in there, shrink wrapped by my uterus, and I had a partial anterior placenta so it dulled the feeling of him even more, but he also liked to face my spine and stay in one position for days at a time, so the majority of his movements were not able to be detected unless listening to him on the monitors or ultrasound.

The approach to treating PPROM began. They kept an IV in my hand or arm at all times (so in the event of an emergency situation they’d have access to put me out) I was on 8 day regimen of antibiotics. 5 days IV antibiotics and 3 days oral antibiotics. They said studies showed zero substantial change in outcome with any more antibiotics than that.

There are many big risks with PPROM but the main risk is infection. Bacteria can get into the sterile environment via the vagina and infect the remaining water and cause the placenta to become septic, which can cause sepsis in me, the mother, and the baby! Cord prolapse is another issue they look out for, where the cord falls out of the cervix because there is no protective bag of water for it to float around in. They also look out for umbilical cord compression since there’s low to no fluid for it to freely move in as the baby gets bigger.

About 25% of women have their baby within the first 24-48 hours of water breaking. Then another 98% after that go on to have their baby within 14 days of PPROM. I was 28w1d and terrified of a NICU baby, but I knew I was in the best hands possible and he had reached a great milestone for NICU success by being 28+ weeks. It still terrified me. I was also really sad because this pregnancy was my last pregnancy, I already had gender disappointment, and every moment with my daughter felt sentimental because I’d never have another daughter to have some moments with. My husband and I even talked about us both feeling that way. Suddenly, my last couple of months with her are ripped away and she doesn’t know why mommy is living at the hospital and why we have hospital dinner every night. Looking back, these seem like small things but they mattered so much to me at the time.

They sent in doctors from the NICU and talked to my husband and me about all of the risks of having a baby at 28-30 weeks. Risks about the fluid rupture and baby’s lungs. Risks about brain hemorrhages. Risks about neurological and developmental issues. Risks about cerebral palsy. Risks risks risks.

I am an optimist at heart and have a pretty bubbly personality, so I began to open up and became friends with nurses (because I saw mostly the same ones at each shift morning and night). They had to monitor the baby 2x morning and night and take my vitals and temperature every 3-4 hours (yes even at night) to make sure I wasn’t showing any signs of infection. If I got an infection or if baby showed signs of distress then I’d either be induced or taken for a c-section.

Frustratingly, my baby was in breech position. I was particularly concerned about a c-section because I have a history of pulmonary embolism due to a genetic blood clotting mutation, Factor V Leiden combined with hormonal birth control pills. The pregnancy with my daughter was right after that event and I was on a really high dose of injection Lovenox blood thinners and was already on Lovenox during this pregnancy. I also had three postpartum hemorrhages after vaginally birthing my daughter, so I knew my risk of blood clot, hemorrhaging, and death was much higher in the event of a c-section.

I had such hope he would turn and I tried every move in the book to move him. I advocated so hard for myself for weeks and got accepted as a special patient to a specific MFM who attended vaginal breech births. Since I previously had a successful vaginal birth, I qualified. He stuck his hand up in my vagina and moved it all around and it hurt like hell. He had to do that to determine if I had acceptable birth canal. Because if baby’s head got stuck, the rescue options are horrifying. They’d cut my cervix. He told me he’s had to do a c section with the baby hanging out and pull it back and out. I was told every horror story imaginable but I genuinely felt that my body could do it.

I labored for 12 hours. They had to give me an epidural immediately upon beginning the induction because of those interventions they’d need me to be ready for a c section or major trauma at any point. The epidural failed with my first and I was very nervous it would fail again. They brought in their most esteemed anesthesiologist and she had it working but it popped out and leaked everywhere. They tried again and it failed again.

Around this time, it had been 12 hours of labor and my cervix made very little progress and baby was going into distress with each contraction and he wasn’t budging from being all up in my ribcage. They said I had two options: leave the hospital and birth elsewhere if I refuse a c-section, or have a c-section. So not much by way of options, but they said they already were put at much risk doing a breech delivery but the fact the baby isn’t budging and is going into distress with each contraction, they just can’t take more risk than that.

I ended up needing a spinal block since epidurals were failing, so a third needle stick in my back, for the c-section. It was such a traumatic and shitty end to the journey. I’m grateful I got to try to deliver vaginally though.

Grateful for modern medicine as well because as I was having a full blown panic attack feeling the pressure as they cleaned my belly in preparation for cutting out my son, the anesthesia doctor was standing right beside me doing an amazing job of countering my brain’s powerful drive to panic. He was also very, very calming and kind. My husband had to be kept out of the room while they prepped me, took off all my jewelry, transferred my numb body from my bed to the operating table, and a torturous waiting game as medicines coursed through my veins.

I had texted my favorite nurse because she routinely worked in the OR and said she’d come be by my side any time day or night that I needed her. She showed up, off work hours, and took my hand. What an angel.

My husband came in and she gave him my hand and then she took my phone so she could take some of the most amazing c-section birth pictures I would ever see.

Delivering my son was quick. They had to tug him out and they told me that he had been very stuck up under my rib and showed him to us. His left side brain looked like it was missing. What happened is that when my water broke, it broke at the top of the bag. My uterus shrink wrapped around him and Mrs Uterus grew a horn to accommodate his growing head up under my rib. The pressure from my rib bone pushed into his head and his brain displaced itself. Truly terrified us. But he was purpley pink and crying, so it was OK. My husband walked away and began to cry. He got to cut the cord and wheel the baby out as I got stitched up.

My favorite nurse came back to be with me during that time as well.

Into recovery room and I am totally out of it after the 12 hours of labor and all that… but my husband is seeming concerned about how our baby is not drinking milk very well and his color looks off compared with our daughter. I didn’t take much thought into this at the time. I was just really freaked out that I felt so paralyzed for so long after the surgery.

When I began to regain some movement in my extremities, they wheeled us to the mom and baby side of the hospital and put my son in an acrylic bassinet and parked him in front of my feet at the end of my hospital bed. My husband was walking around the room on the phone with his parents, who were watching our daughter, when I got very concerned with the stillness of our new baby and asked him to check on him.

It concerned me further when the check was an extended check and a “I’ll be right back.”

He had the nursery nurse come check on our baby boy and she was standing there with her stethoscope for too long and I knew something was wrong. She told us she’d like to take him to the nursery to monitor him. But I knew.

About 30 minutes later they came into our room with a giant NICU isolette with bilirubin blue lights on our son. Told us he’s going to the NICU. His oxygen was 80% and he wasn’t behaving normally.

I didn’t cry. I was too much in pain and out of it and traumatized from everything so far to cry.

I was pumping every 3 hours and dealing with the worst gas pain imaginable for a couple days. My husband would walk up to the NICU to visit our son and bring back pictures and stories about what was happening. I didn’t see him for a couple days because of my pain. When I did go up to see him, I could only touch his hand. That’s when I lost it and wept. I started making drops of colostrum and then I was motivated to bring those up to him. Every time I pumped, I’d suck the colostrum up with a syringe and start practicing my walking 🚶‍♀️ to get up to the NICU. Then on day 4, on Halloween night, they released me from the hospital. My daughter dressed as her favorite Disney character skipping happily down the hall was the highlight of leaving the hospital because we went home without her brother.

The next day, I kept pumping and the comfort of home caused my milk to come in more so I started what would be a 15-day routine of pumping milk into little 2.5 oz bottles, labeling them, and taking my pump basket and stuff to the hospital.

At the hospital, I’d drop my milk off with the milk bank and they’d give me a voucher for a lot of free food in the cafeteria, which was truly amazing because the food was fire. Too good to be hospital food. I was also fucking starving so the free lunch was a great perk. I started off by spending a couple hours a day the first week with him in there. He had to have a chest tube placed to drain the fluid accumulating in one of his lungs. He was higher needs so he was out in the open with all this commotion around. Then when he leveled up and got his own private room and transferred to a less intense NICU bed, I began to come for a full day morning to night.

He was there in the NICU a total of 15 days, but it was not that bad because I was so focused on recovery from the c-section, dealing with pain medicine, getting into a new routine, pumping, etc. That the days flew by. Only by the last few days did I start to get antsy. On that Sunday, our entire family went to the NICU to go visit (we could only go up one adult at a time so we took turns as each of us hung out with our daughter since she was too young to go to the NICU to visit him). They surprised us and said they were discharging our baby boy!

Once he had recovered from his lung issues, he had to learn how to drink milk without hyperventilating, holding his breath, falling asleep while drinking, or choking. That took longer than anything.

But I worked with him daily and got him on a good rhythm to make sure he drank his entire bottles. The SLP (speech language pathologist) gave us some good tricks as well to get him to drink without falling asleep.

The surprise to take him home was a welcome one and we were thrilled.

My first few weeks home with him weren’t the best for me mentally. I definitely had some dark days and worried about myself. I chose to go back to work and start a new job at 1 month postpartum and slowly ramped from 20 hours to 40 over the course of a month and a half. I hired a part time pediatric nurse nanny. It helped me gain a sense of self again and occupy my mind.

Now my baby is 4 months old and I love him very much. He’s cute, and aside from having some mild eczema, he’s a normal happy healthy baby boy now. I am blessed again with an oversupply and I’ve lost all the baby weight and more. My job is going well, I have a full time nanny, and things are looking good in life.

Thanks for reading! Let me know if you have questions because when I went through this, I had all the questions.
I sometimes wish I wrote more of a diary but I didn’t have the mental bandwidth to do that at any point in this journey so I’m certain there are things I missed. It’s also taken me 4 months to even write this update because it’s been a struggle. I never had to go on antidepressants, but I was close. It’s taken some significant work on my part to hold myself together. But I’m safely on the other side now and I’m never going to be pregnant ever again: IUD in place and vasectomy for the husband. Pregnancy is complicated, often challenging, and full of risk, which is why it should always be a choice.
 
@mrexpress Hi! We communicated when both of us were in the hospital at the same time for PPROM. I am so, so happy to see this update, and so glad that you and baby are healthy and safe. You are a warrior!!!!
 
@marouane Hey! I am so glad y’all are doing well too! Thanks for being there with me. So grateful for the internet connecting those of us in unique situations. 🫶
 
@mrexpress Congrats! My second was also PPROM (28+6-> 33+1) and being without my 2yo was so rough! You can really see the impact of holding out so long since your NICU stay was relatively short. My son's was until his due date, but I'm still thankful we made it to 33 because he was able to avoid breathing support.
 
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