BV and PPROM/ 2nd Tri-loss/Pre-term birth

Amber&Reva · August 2014

I had BV with my first pregnancy late in the 1st tri and ended up PPROMing at 18w. Pregnant again and found out at my 10w check-up I have BV again. Curious if anyone had BV and also had a late loss or other pregnancy complications? Through studies it has been determined that there is a link between BV and pregnancy complicaitons so I am just wanting to hear others outcomes when BV was found.

thekingsmommy · August 2014

What is bv?

smagglebit · August 2014

Bacterial Vaginosis

I don't know how accurate this information is, but I was recently told that they think about 95% of PPROM cases are caused by infection of some sort. I would like to look into that and find out if there is more information out there to back that up.

I had PPROM at 15w6d, after which my baby boy hung on for 10 days. I lost him 9 days ago at 17w2d, and I'm now trying to research as much as I can about this. It was my first pregnancy. I went into the ER the day before I went into labor with symptoms of a UTI and light bleeding (the bleeding freaked me out and prompted the after-hours ER visit). I was prescribed antibiotics at that point, but I think it was too late. No idea if I had BV before my water broke.

At about 2:30 the next morning I woke up in pain - I recognize now that I was having contractions, but at the time I thought the UTI had moved to my kidneys. Feeling the need to go to the bathroom, and wanting to check if the bleeding had gotten any worse, I got up and used the bathroom, to discover I was having a miscarriage. My hubby called 911 and I was taken to the hospital in an ambulance. I know that they took blood samples in the ambulance and at the hospital and my husband said that after my D&C they had a sample of what looked like tissue.

I have a follow-up appointment with my OB tomorrow, and I have lots of questions for him already. Hoping that he'll have some answers for me. I've been aching to have a child for 8 years, and losing my sweet little guy has been heartbreaking. We're still unsure if we're willing to go through it again.

Amber&Reva · August 2014

I am so sorry for your loss. I PPROMed at 18 weeks and was induced because of the risk of infection. After 36 hrs of labor my daughter was born. At the time I didn't think anything of the BV as it had happened and as far as I knew been resolved about 8 weeks prior. This time around when I once again had/have BV I demanded oral antibiotics because after some research found that topical antibiotics don't help with pregnancy complications. I wonder if there would have been a different outcome if I had oral antibiotics last time around.

After my follow-up appointment it was found I had a staff infection however they were unable to determine if my water breaking caused the staff infection or if the staff infection caused my water to break.

Reading the correlation between BV and PPROM made me wonder if anyone else has had similar outcomes after having BV during pregnancy.

angieddaniel · August 2014

I pprom'd at 18 weeks and I'm almost 24 weeks now and have not contracted an infection yet. My baby is doing well despite 2cm of fluid. I am being admitted to the hospital on Monday for hospital bedrest until my baby decides not to stay in anymore. My pProm was suspected to have been caused by my sub chorionic hemmorage (blood clots) in my uterus and I had been bleeding off and on the whole pregnancy. A good source of information on this subject is aapprom.org. You should add your stories to the registration so the website's statistics can be even more accurate. Then there is a babycenter.com group called pProm support group and the women that run the American association of pProm are in the chat group and can answer a lot of your statistical questions based on the registry from the website. This is where my research led me and it has been a wealth of information.

Amber&Reva · August 2014

@angieddaniel did your OB practice try to pressure you to deliver right away? When I PPROMed I was told delivery was the only option and I trusted my OB and the warning she gave me so I let them induce me. After I returned home from the hospital I read stories about people that were able to continue to carry for weeks even months after PPROMing. FX it doesn't happen again this time around because I would hate to go through it all again but at the same time if it does I do have a lot more information and know that delivery isn't the only option. Unfortunately I don't think my practice was very comfortable or educated in PPROMs and handled the situation in the best way they knew how. I hope you can keep that baby cooking for a very long time

Amber&Reva · August 2014

I have been on the babycenter group after my PPROM back in February I did a ton of research. Every time I try to go to aapprom.org my browser says sight doesn't exist.

Mrsgclark81 · August 2014

HI, I faced the same problem with my last pregnancy. I had BV and went into premature labor at 20weeks. Whenever I discuss what happened with an OB they resort to stating "facts" and statistics on how its normal for women to have BV during pregnancy and how there aren't any prevalent studies that show a connection between BV and PROM.

It's been really frustrating and scary because I feel like the doctors don't know what they are talking about. During this pregnancy (14 weeks) I have been proactive in any symptoms and treatments, I really feel like I've been my own doctor, which is scary. I just finished antibiotics for BV because I had it again.

smagglebit · August 2014

So just wanted to let you know about my follow up OB appt yesterday. He said that they screened me for BV during one of my regular visits (prior to PPROMing), and it had come back negative. He doesn't suspect that I had an infection prior to PPROM. He did say that in my case, it's possible that I have Incompetent Cervix, but he can't know for sure until I get pregnant again. He did reassure me that I would be monitored very closely in future pregnancies. They should be able to catch it earlier next time and hopefully prevent a loss. I'm grateful for that, but I'm scared and I don't wnat to go through this again $:\$

Amber&Reva · August 2014

@smagglebit my MFM also said that I will be monitored this time around for IC. She said this because "every other cause of PPROM is so uncommon." So I should start cervical checks at 16w I am currently 12w and also assuming insurance approves it start p17 injections around the same time. My problem with accepting that I have an IC is that it took them 3 days to get me to dilate after I PPROMed the delivering midwife told me I had an iron cervix because she couldn't get anything in it to get the birthing process starting.

Amber&Reva · August 2014

@Mrsgclark81 I also got BV once again this pregnancy around the same time I got it last time. Thank god I had done my own research because the doctor wanted to give me topical antibiotics however from doing my own research topical doesn't help with pregnancy complications it only masks the symptoms so I had to ask to take oral antibiotics instead. I am also going to ask that the closely monitor me for BV coming back as from my reading it does about 60% of the time.

Mrsgclark81 · August 2014

Amber&Reva said:

@Mrsgclark81 I also got BV once again this pregnancy around the same time I got it last time. Thank god I had done my own research because the doctor wanted to give me topical antibiotics however from doing my own research topical doesn't help with pregnancy complications it only masks the symptoms so I had to ask to take oral antibiotics instead. I am also going to ask that the closely monitor me for BV coming back as from my reading it does about 60% of the time.

MFM wants me to do the same thing, starting at 16 weeks check for dialation and give me progesterone shots if I start to dilate. However I just started a new job and the MFM office is only open Mon through Fri and their latest appointment is 3:30

I don't know what to do now. All of the hospitals I called have the same MFM hours/days !

Amber&Reva · August 2014

@Mrsgclark81 I've heard that after the first p17 shot the nurse can teach your SO to do the shots at home. I don't know this as a fact yet because I am not at 16w yet. I know this doesn't deal with the cervical check issue.

angieddaniel · August 2014

I was not pressured at all about terminating the pregnancy. In fact I don't even think she listed it as somrthjng to consider. This was from my neonatologist. She did tell me the risks of getting an infection and if I did they would need to take the baby out. But at that point it had almost been 3 weeks since I believed the pProm happened and I didn't have any signs of infection yet. It seemed to me that she felt comfortable enough in treating me after I showed signs of infection, that my life wasn't in mortal danger. I live super close to the hospital etc. she did give me the likelihood of the baby's survival but also made sure we knew there was a chance that she could survive. And the baby herself looks good and properly forming so far with a strong heart. So I always had a little bit of hope even from that first day of diagnosis.

angieddaniel · August 2014

https://aapprom.org. See if this link works.

blueberries8 · August 2014

My heart goes out to the other PPROM mamas. I PPROMed at 19w2d with my twins a couple years ago. I had a SCH in the 1st tri which became a chronic abruption and resulted in a big bleed at 16 weeks. In my case, it was thought that the bleeding caused PPROM either by chronic inflammation or by infection (apparently pooling blood in the uterus is considered a perfect medium for bacteria). I was under strong pressure to induce even though one baby's sac was still intact. The ruptured sac was completely ruptured with no hope of the fluid replenishing. I held on for about a week before I started contracting on my own.

Last year, I had a healthy pregnancy. Emotionally it was very stressful but ultimately, I carried my daughter til 37 weeks. From weeks 16-24 I had a weekly ultrasound to measure cervical length. There wasn't enough evidence to warrant a cerclage from the outset, so we chose the expectant management route with the idea that we could hopefully intervene in time if my cervix started to shorten. I also had swabs for infection at 12 weeks, 16 weeks, and I believe also 20 weeks. I was on progesterone from weeks 20-36 and I took baby aspirin from conception until week 34 to help with any possible placental issues. I also had a detailed placenta scan at week 22 and I was offered a course of steroid shots to be taken between weeks 24-28 to improve my baby's lung function in case I went into PTL during that time.

I just wanted to give you guys an idea of some of the things you can ask for in terms of monitoring a subsequent pregnancy. In my case, most of these things were ultimately precautions since my pregnancy was largely problem-free.

Also, there are 2 very active PPROM FB groups - Life After PPROM Loss and To Catch a Rainbow After PPROM Loss (for those pregnant after PPROM). Definitely worth looking up for info and support.

Amber&Reva · August 2014

@blueberries8 I am so sorry for the loss of your twins and thank you for sharing your experience with your second pregnancy. I am getting my first cervical measurement on September 10th. I also want to ask about them monitoring me for any form of vaginal infection since I have already had one this pregnancy. They are waiting on approval for p17 through insurance and if that doesn't get approved I'll be doing the vaginal progesterone.

angieddaniel · September 2014

I've learned in many sources to avoid exams unless it's an emergency. To monitor for infection for me right now I have my temperature taken every 4 hours and basically watch for symptoms. Since I'm in the hospital right now they take blood and check my white blood cell count every 3 days.

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