Pprom

andrea z · September 2009

Hi ladies. About two weeks ago our baby A's membrane ruptured. Baby B has his own sac and is doing fine. I am not contracting or dialating. The peri's main concern is infection. I am on hopsital bedrest until they are born... and our short goal is 28 weeks, but they will let me go to 34 weeks. I was wondering if anyone else had this situation and how long did you make it without infection? We are praying to at least make it to 24 weeks, so that our twins will have a chance... but I would love to keep them in as long as possible.

tmp-303869625008161 · September 2009

With my singleton pregnancy, my water broke at 21 weeks 4 days. Like you, our goal was 28 weeks, but would have been allowed to go to 34. I never had contractions and never developed an infection. My son was delivered via urgent c-section at 27 weeks 3 days because the lack of fluid was causing him to compress his umbilical cord making his heartrate drop. It had been happening for almost 2 weeks by the time he was delivered. But the morning they decided to take him, he had been on his cord a lot more than usual and it was decided that he would be safer out than in.

Good luck! Keep baking those babies!

lemen99 · September 2009

I"m sorry you are going through this

I delivered early because of a different problem, but, I've heard several success stories of women in your situation. I'll be praying for you and that your babies make it for many, many more weeks!

kkh2002 · September 2009

Mine was a single pg, but my water broke at 23w1d. I carried to 27w3d when I had an emergency c-section because of placental abruption and contractions. I was on hospital bedrest with frequent monitoring (and ridiculous amounts of antibiotics) until delivery and received the steroid series at 24wks. DD is almost 7wks old and though it will be 5-6 more weeks before she comes home, she's doing quite well. Her lungs were our main concern and they are MUCH better than even her neonatologist thought they would be.

Good luck!

Kaytee1206 · September 2009

Congrats on making it 2 weeks already, thats a big deal!! I was told by my MFM's that people usually deliver within 2 weeks after pPROM. I had pPROM at 24 weeks with my dd and managed to stay infection/contraction free until I was induced at 34 weeks. I did spend that whole time in the hospital. At one point they thought my leaked had sealed, but started right back up a couple of days later. I did received the steroid shots right after I ruptured which I strongly believe makes a HUGE difference.

How big is your leak? Is there any fluid left around baby A?

You should page Nbjenni on the multiples or 6-12 month board or read her blog at https://nbjenni.blogspot.com/ She had twin girls and one of their sacs broke like yours. Her leak sealed and she carried her babies until 35 or 36 weeks I believe. Her blog gave me so much hope while I was in the hospital.

Good luck and my prayers are with you. Keep those babies cooking as long as you can.

MarriedBestFriends · September 2009

I pPROMed at 34w4d and did not go into labor. They started my induction at 35w3d after a week of hospital bedrest and antibiotics. I had plenty of fluid remaining and had 2 BPPs to check on it plus constant monitoring. During induction we discovered that I had a sealed forebag that actually had to be broken and was probably keeping any infection at bay. Somebody posted a site on here that I referred to that had great success stories of pPROM ladies but I can't remember what it is....maybe try to google??

kkh2002 · September 2009

I should also add that in the four weeks following my rupture, I never had more than 3-4cm of fluid. More than once, I had no measurable fluid at all. The reason for my preterm rupture is still a mystery - my pregnancy was textbook up until that point and I had no other problems after the rupture.

andrea z · September 2009

Baby A has almost no fluid around him. The peri has not given him good odds. He said that since he has not had fluid since 20 weeks, he has about a 1-2% survival rate after birth. This also depends on how long I can stay pregnant. The peri thinks baby a's lungs are just not going to work well. He also said that we will just have to wait until birth to know for sure. Some surprise him. How were your babies lungs when they were born? They also said he might have some issues with tight muscles, since he can not move as much without fluid. Anyone have this problem?

Baby B has normal fluid levels, but they are concerned about his water breaking also. We get weekly ultrasound checks to be sure he has plenty of fluid.

southphilly · September 2009

First of all-Good Luck-I am thinking about and praying for you and your twins. I had pprom at 22 weeks, made it to 24.5-not long, but long enough. My son is 9 weeks ( 34 weeks gestational age) and still in the nicu-for probably at least another month. No ill effects from the lack of fluid, but obviously a ton of prematurity issues, mainly respiratory. I had tons of antibiotics and steroid shots. My baby is going to survive due to those 2+ weeks-hang in there. there is a really good pprom website but I am totally spacing on the name.

kkh2002 · September 2009

I was a few weeks further along than you when I ruptured, but we were not given good odds either (for delayed delivery, survival or the potential for long term disabilities). I recently got a copy of the neonatologist's notes from the night of DD's birth and even then, he didn't seem to expect much from her. Her APGARs were 3, 5, and 6 (at 1min, 5min, 10min) and her first chest x-rays was almost completely white because her lungs had such a hard time inflating. She received several doses of surfactant and each x-ray was progressively better. She was ventilated for less than 48hrs and was weaned from her CPAP (to nasal canula) at less than three weeks. None of us expected things to move that quickly, though I recently read in one of our preemie books that babies that are under stress in utero sometimes have better lungs BECAUSE the stress encourages faster production of the natural surfactant in the lungs. One of the stresses mentioned is prolonged lack of fluid.

As for muscle tightness, DD's hands and feet were sort of...bent?...in an odd way from the pressure of my uterus around her - nothing I noticed right off, but the doctors made mention of it and now, looking back at early photos, I can tell. But it's no longer an issue at all and her muscle tone is great.

We were devastated when all this began but we had great doctors reminding us each day that every baby is different and that every day you can ward off delivery is a good thing.

Hang in there - prayers for you and your babies.

southphilly · September 2009

kanalen.org/pprom BUT I really caution against reading the loss stories-you need to keep as calm and stress free as possible-stress can cause contractions. fwiw, I had significant contractions on multiple occasions that eventually subsided.

Susan_KW · September 2009

I had a singleton pregnancy and ruptured at 30 weeks 5 days. DD was born ~36 hours later at 31 weeks exactly. She wasn't in distress, I went into labor naturally. At that gestational age they do not try to stop labor with pPROM.

DD is fine now and never showed any sign of infection, nor did she need a lot of oxygen support. She was on CPAP (basically room air) for 2 days and then a nasal cannula for another week.

Your situation is very different from mine, but from what I remember reading the earlier the rupture occurs the less likely you are to go into labor soon after rupturing.

I wish you the best.

AFwife1106 · September 2009

I ruptured at 27w 3d and didn't go into labor until 28w 6d.. so 10 days. I didn't have any sign of infection. LO's heart rate would drop but it always came right back up so they were never that worried about it. She was VERY active too, so I always joked that she liked to kick her cord.

They were going to keep me until 34 weeks if they could. I got the lung shots when my water broke.

LO's breathing has been amazing, beyond impressing her NICU doctors. She was on a ventilator for 8 hours and the CPAP for 10.. She's been breathing room air (so no oxygen) for over a week. She still needs some pressure but it's minimal.

PP about the earlier you rupture, the longer you last is right. My doctors said the same thing.. they also said the the main reason women have their babies after a rupture is infection.. they were really surprised when I randomly went into labor on my own.

LO didn't have any real fluid when they would do the ultrasounds. They never said anything about muscle issues.. she doesn't have any now either.

HTH.. GL!

hailie · September 2009

I had pprom at 33w 2d & delivered 5 hours after rupturing (labor progressed immediately & too quickly to stop it). I hope that you can continue to hold out for a few more weeks. I will be thinking about you & your babies.

Million$$Baby · September 2009

Baby A's (Charlie's) water broke when I was 24w3d. I spent 9 days on hospital bedrest until I suddenly went into labor. I never contracted an infection. My only suggestion is to pay very close attention to how you feel. Looking back, I was having contractions on and off for a few days and did not know it. I really didn't know what they felt like and the monitor wasn't picking them. I wish I had known - not sure if it would have made a difference but it nags at me.

Hang in there - you can do it!

Million$$Baby · September 2009

andrea z:

Baby A has almost no fluid around him. The peri has not given him good odds. He said that since he has not had fluid since 20 weeks, he has about a 1-2% survival rate after birth. This also depends on how long I can stay pregnant. The peri thinks baby a's lungs are just not going to work well. He also said that we will just have to wait until birth to know for sure. Some surprise him. How were your babies lungs when they were born? They also said he might have some issues with tight muscles, since he can not move as much without fluid. Anyone have this problem?

Baby B has normal fluid levels, but they are concerned about his water breaking also. We get weekly ultrasound checks to be sure he has plenty of fluid.

Charlie had zero fluid for 9 full days. His lungs are fine. Normal preemie issues but he's breathing like a champ right now on the nasal cannula, same as his sister who never lost any fluid. I was further along than you when my water broke, but hopefully your little Baby A will be just fine! I'll be thinking of you!

pmkmp · September 2009

My water broke on our son at 21.5 weeks. Our daughter's did not. They managed to stop labor and I was put on 100% bed rest in the hospital for as long as I could hold out. I received steroid shots to help build the babies' lungs up. Our son had very little fluid around him (around 3 to 4) most of the time. I managed to hold out for 6 weeks until I went into unstoppable labor. (Delivered at about 27.5 weeks.) Our son almost didn't make it through the first day, but held on for 8 days until he passed. We were told that boys have a much harder time than girls who are born early, plus he was so low on fluid from such an early gestation age, so his lungs were horrible. After he passed we did decide on an autopsy and were told his lungs where pretty much non existent. Our daughter is now a year old and doing great for the most part. There is still no known reason behind my pprom nor do we know what sent me into labor (infection maybe?). I wish I had a happier story for you, but just know that you are doing everything you possibly can and stay strong for those li'l ones. Miracles DO happen and your story could end up very different. I pray that it does. If you have any questions or just need to talk, I will be more than happy to be there for you! ((Hugs to you))

JenniferHolly · September 2009

I made it almost 5 weeks after my water on baby A ruptured at almost 25 weeks. I never got an infection (thank goodness). I went into preterm labor probably because the placenta started abrupting (from being ruptured on baby A).

My boys did very well. The baby that was ruptured had a MUCH harder time respiratory wise (needed the vent for a bit and had chest tubes). We were really lucky that they didn't have any brain bleeds or ROP etc.

It is possible to go awhile after you rupture (especially the earlier you are when you rupture). To help keep infection at bay I would suggest lots of water, stay out of the water besides a shower, change your pad every time you use the rest room and STAY OFF YOUR FEET!

There were 2 girls in the hospital with me that ruptured and went over 6 weeks before delivering. If you make it through the first 48 hours after delivering, your chances are good that you will go longer! It is in your favor that you are pregnant with twins because baby B's bag will cushion baby A. Also, if you go into active labor before 28 weeks with baby A inquire about delayed interval delivery (buying baby B more time).

Good luck! Thinking of you!

andrea z · September 2009

Thanks for all the feedback ladies. Fingers crossed we can stay pregnant as long as possible. I don't mind being in the hospital if it means our babies will have a better outcome. We had another ultrasound today and nothing has really changed. Baby A has almost no fluid and baby B was dancing around like a wildman. I just wish we could snap our fingers and be past 24 weeks. At least then they have a chance...

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