pPROM at 15 weeks. Any chance of success?

I am currently on bedrest with baby #3. My membrane ruptured at 14w5d. I went the doctor that day and she told me that I had not ruptured and it was very common for your bladder to leak with the third (eventhough I said it was exactly the same as when my 1st son ruptured at 31 weeks). When I went back the next week, she realized that I had ruptured and there zero fluid left. She got me in immediately with the perinatologist. He was very grim about the chances and sent me home on bedrest. The next week I went back to the doctor there was a little more fluid and the baby was growing. It has now been 3 weeks since the rupture.
I guess my questions are 1. Has anyone has a successful pregnancy after such an early prom? And 2. What did you do to help your pregnancy? I feel like my doctors have written off this pregnancy and have not done anything proactive besides put me on bedrest and set up weekly check ups.
I also tested positive for bacterial vaginosis and I am on antibiotics. I am nervous about a more serious infection.
I am bored to death on bedrest and would love to hear anyone's stories or advice.

Edited July 4, 2011 at 3:40 pm

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To be honest with you, the odds here are not in your favor. The sad truth is that most likely this lil baby wont make it. The doctors are acting the way they are because of this and the fact that there is nothing more they can do. That said, if you are still pregnant at 24 weeks INSIST they admit you to the hospital and stay until you deliver. From then on the baby at least has a fighting chance!!!

When I was in the hospital with my 4th baby (water broke at 31 weeks, delivered at 32 weeks) there was a mom next to me who had her water break at 16 weeks. She (like you) was given little hope and sent home on bedrest and antibiotics. They told her if she was still pregnant at 24 weeks they would admit her. She was, and they did. For 7 LONG weeks she laid in the hospital trying to prolong her pregnancy as long as she could. The same night I delivered my 32 weeker she delivered a 4 lb 1 oz 16 inch 31 week baby boy. He spent 3 long months in the NICU with severely underdeveloped lungs due to being without fluid for so long, but.... he went home with his mommy. It doesnt happen very often, but it DOES happen. There are a few moms on this board who have had prolonged PPOM as well too.

Best wishes to you, I will keep you in my thoughts. I hope you have a great outcome. Please let us know what happens (((hugs)))

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Hi, I had pprom at 22 weeks. I was admitted and told that the baby wouldn't make it if I delivered that day. I was already dilated 4cm and my water was leaking completely. I was put on bedrest at the hospital, which I was fortunate to be at a Level III Nicu hospital. I was not able to get out of bed for anything. Was told to drink lots of fluids and avoid pushing down when having a bowel movement. I was able to hold out 10 days and my baby was born at 23. 6 days. I think you should first find out what hospital you have available if they do have Level III. Also, continue your bedrest and drink a lot of fluids to replenish your amniotic fluid. You should insist on getting admitted if you make it to 23 weeks and receiving steroid shots for baby's lungs. I got these a week before he was born. My baby spent 102 days in the NICU and we have been home now for almost 2 weeks. He is doing great, his lungs still need that extra O2 support but he is a true miracle! Most importantly, pray and speak with God and ask him to take over. I hope it works out!

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My DIL had prom at 15 weeks exactly, the membrane did not heal and she was able to retain only a tiny amount of fluid. She went on bedrest except for using the toilet and a shower every other day. At 24 weeks she went into the hospital. It was very difficult for her as she is an active, go-getter type of person but her husband delayed starting a new job and they have no other children so that helped except for the boredom. Our grandson was born at 28 weeks exactly. There had been one steroid injection. His lungs were very tiny and it was a very scary beginning, the doctors did not have much hope. But the little guy came home from NICU a week before his due date, was off oxygen at 4 months actual, off monitors at 6 months actual. He babbles, smiles, puts objects in his mouth and can control his head. He's had some physical issues due to being "squished" before birth. So - as the previous poster commented it is unusual to have such a good outcome but it does happen. I'll be thinking of you and sending positive thoughts.

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I disagree that it is unusual to have such a good outcome. My drs said that if you can get past the critical first 72 hours & then the first week, the odds are in your favor to hang on a while. I had Pprom much later (~24 weeks) with twins and managed to hold on until almost 33 weeks. I was very lucky in that my boys spent just a month in the nicu & are doing great. I spent the first week in the hospital on iv antibiotics to make sure there was no underlying infection causing issues, but after that was told it was actually better to be home & away from the risk of infection in hospital. I went in 3x week for all sorts of scans & tests but otherwise was at home on strict bedrest (tons of water, lay on left side, stay away from all visitors & any germs). When I was in the hospital there were several other women who had also been on bed rest for 1, 2 or even 3 months after pprom, so please hang in there. Also, as soon as you get to 24 weeks, get the round of 2 steroid shots for the lungs. Then if you can hold on another few weeks, get another round of them. Good luck!

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has anyone spoken to you about fluid replacement? or have the membraines healed.

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There is HOPE! Please don't listen to all the negative answers you get - especially from doctors. I ppromed week 10+6 and delivered twins week 25 and 26. The later twin survived and is doing great. Please visit this great group for support and realistic information: http://community.babycenter.com/groups/a6718373/pprom_support_group. There is also some facebook groups with mothers currently on bedrest and doing fine!

All the best wishes and feel free to ask questions

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MEK, how are you doing? Any news? There are many of us out here with nothing to say that would be helpful but are supportive (although from afar) and wishing you well, very well. Take care -- and enjoy that bed rest. I only had to endure 11 days of it so I know the boredom ... but yours will be a long while yet. Try to stay positive. www.sidelines.org supports women on bedrest, if you need someone to coach you virtually. Just having a friend can be helpful on your down days. :)

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Thank you to everyone for such great responses. I am new to this site eventhough I have a 4 year old who was a preemie. I know the odds are definitely not in my favor, but it is nice to hear some happy endings.
I am going to see the perinatologist for the big 1/2 term ultrasound next week. He mentioned two weeks ago that he would be willing to try amnioinfusions if the rupture had not healed by our next appointment. Has anyone tried this process of injecting fluid through an amnio needle? Did you think it was helpful? How painful was it? Or did IV fluids help anyone? Also, the doctor said that if the baby survives, he/she (I find out on Tuesday) will most likely have severe disabilities. I am alright with that, my husband is a severe special we teacher and my BIL is severely disabled. I just want to know what type and how severe the disabilities can be.
For those of you with a preemie in the hospital or recently brought home, I want to give you a little encouragement in return. My oldest was prom at 31w born a few days later at 3 lbs 9oz. For the first month he was on IV nutrition because his digestive system was not working and he had daily apnea episodes. After 5 weeks in the hospital, he made it to 5 lbs and we were able to bring him home. Since then he has had zero health problems and I actually forget that he ever was a preemie. He did hit ALL of the benchmarks late, but once he hit them, he excelled. He never needed any PT OT or speech. Everytime we were nervous about him falling behind, he would catch up before we got into the therapist. He is such a healthy 4 year old, no one would ever expect he was a preemie.

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I had PROM with one of my triplets at 15w3d (identicals - they shared a placenta so if one died, they all would) - all survived and thrived. I want to add that the fact that it's been 3 weeks, you're not in labor and you're still pregnant are good signs. We did not do amnioinfusion, so I can't help you there. When my girls were born at 29w4d (due to bad pre-eclampsia), my little one with the PROM had the hardest time due to very small (hypoplastic) lungs. She battled it out, but she was a fighter, and I think sometimes it depends on how much the baby wants to go through. We had a Level 3 NICU and very aggressive docs. My daughter had a clubfoot (positional, not misformed bones) due to her being squished so much due to lack of fluid. Eventually after 9 months, she lost her hearing, probably due to low birth weight, extended vent etc. She ended up coming home on oxygen (not a trach/vent, only nasal canula) and had a g-tube (she could suck and swallow OR breathe, not both, and my little peanut chose the right thing - to breathe!)... She ate/drank normally by the end of her 3rd year and she got cochlear implants and learned to listen/talk so she's doing great and totally on par with her sisters. The clubfoot resolved with two short castings and some P.T. She also had a couple hernias due to her struggles to breathe - it's really something to see a little one fighting to breathe, but she pulled it off and had surgery with no problems and the hernias got fixed.

So - we had issues. At 8 years old, she's smart, runs around like crazy, is ahead of grade level in school with her sisters and you'd never know about her hard start except for some surgery scars from the g-tube and of course, her cochlear implants. She's just a normal kid now.

So... yes things can work out. I hope they do for you. I remember well how horrible it was on bedrest wondering how we'd do. A couple things I did -
1. Asked the doctors to manage me as if this was going to work. They thought I was hopelessly unrealistic that I wouldn't accept induction. Fact is, some kids DO survive and thrive after very early PROM. The odds may be low, but why shouldn't you be the one to beat the odds? You're doing well now, you've stayed pregnant for a long time already (past when many who don't make it after PROM have already delivered) and you need your doctors to support you.
2. Talk to your baby. Tell him or her to find that pocket of fluid and practice breathing to grow lungs. Early PROM is bad b/c kids haven't grown lungs and an early PROM baby faces a lot of oxygenation problems with small lungs - extended ventilation (sometimes early PROM kids get a trach and a vent and then slowly as they grow, their lungs do better and they can get off it in a year or two).... others do well and don't need that. But the key is lungs. So have your baby grow lungs - bigger and stronger the better to help for after birth!!!
3. Drink lots of water to help get more fluid for baby, and to avoid contractions. You really don't want contractions and dehydration can cause them. (follow doctor's recs on this...)
4. Stay pregnant as long as you can safely do so ... and its corollary: Know the signs of preterm labor - not the same as regular labor. Ask your care provider... for me preterm labor felt like I had to go pee every 4-5 minutes, really badly... others it's a recurring backache, other things too. You want to make sure you have early intervention if you feel labor.
5. Tell your baby often how much you love your baby and want him/her to stay with you! You're a team!

Whatever the doctors said to me that needed to happen, I'd visualize that for my baby, and somehow it was if she listened and did what needed to be done. So find out what needs to happen for you - calm body, no labor, tight cervix, no infection, and whatever baby needs to do (grow lungs etc) and try to communicate that to the baby so that you and your baby can team together to make it happen.

I'm incredibly close with my daughter because of all we went through together. Good luck to you - I hope so much for a happy ending for you both. Hang in there, you're doing the right thing asking for positive success stories to balance out all the negativity! I'll check back on you!

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PS for bedrest - it does get better after the first few weeks. Do it, as hard as it is - there are some online bedrest support groups. I watched the entire Buffy the Vampire Slayer series on DVD during my pregnancy, plus a lot of home makeover shows etc. I couldn't concentrate on much but if you can, teach123.com has some great courses on DVD that are excellent and would stimulate your brain. Get visitors.... food by the bed in a little fridge...

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By the way, there is no evidence that bedrest early on in pregnancy prolongs a pprom pregnancy - rather bedrest can be very harmful to the body. Moderate bedrest might actually be healthier for both you and the baby.

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Perhaps, perhaps not... early prom and late prom are different from each other as well. If you have questions, please address them to your perinatologist.... It's great to question and advocate for your care, not so great to make changes to a plan without consulting them...

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Thank you again for your inspiring stories and recommendations. Unfortunately, at the doctor yesterday the ultrasound showed such low fluid levels that she couldn't even measure them. The baby still is growing somehow. Besides bedrest and drinking a ton of water, what else did you do? For those of you who had successful pprom pregnancies, what were your fluid levels?

Also, ever since I have been pregnant I have had horrible allergies. I sneeze and blow my nose constantly. This usually wouldn't be a big deal, but everytime I sneeze I can feel myself leak fluid. Do any of you have any pregnancy safe remedies that I can do on bedrest.

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In the 13 weeks of bedrest between pprom at 15 weeks and delivery at 28 weeks my DIL's fluid was at a high of 6 only twice, many times it was too low to measure, the typical was about 2 or 3. I did forget to mention in my earlier post that our little fighter is now 6 1/2 months actual age now. He rolled over for the first time today! I'm hoping for the best for you and your family.

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I am 25+3 after having prom at 22 or maybe sooner. I've had antibiotics and steroids and thankfully haven't gone into labour. My obstetrician agrees that there is no evidence that bed rest helpsbut wants me to stay in hospital for another 2 weeks or so in case I labour very quickly or have a cord prolapse. My afis have been variable one less than 2, some as high as 8. I am patiently counting away days and hoping for the best.

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This is a really lovely entry, thank you very much.

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I was 15 w3d pregnant with my 3rd and my water broke. She is now 14 months old and doing fantastick!! She was at the critical level of no fluid as well. She was squished and somehow she got fluid and grew. Her face was right next to the umbilical cord and there must of been a pocket of fluid that she just kept drinking from and she was born at 25w1d. 122 days in the NICU and now home :) I was put on modified bedrest. I got to sit around all day on the couch, but I could get up to go potty and shower (had to sit in the shower....cannot take a bath...fear of infection getting in there) and my husband would set me up with just about everything I would need for the time he was gone. We have 3 other kids (oldest is my stepdaughter) and he was unemployed, just laid off from work....so he was home all the time and helped out a lot! I watched the entire series of Buffy the Vampire Slayer as well! LOL I also watched the entire series of Sex & the City and I read the entire series of Twilight. I would sit on a lawn chair outside to see my other kids, since they always wanted to be outside and I missed them. Any questions please feel free to ask! :) Keep the faith, think positive and pray!! I prayed at least once a day and did a devotional every day...I think there was a few days I did one twice. :)

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Checking back and hoping you're still doing well!!! My AFI was 2 and under for all checks... so you seem to be doing really well. :)

Just keep talking to your baby - find that fluid and grow your lungs, grow your lungs, grow your lungs... Stay inside and grow your lungs. Over & over! Oh, and I love you doesn't hurt too! :)

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Well it certainly won't be easy but I had pPROM at 23 weeks after miscarrying a twin and having several subchoriontic bleeds along with my placenta separating from uterine wall. My doctor immediately admitted me to the hospital after the membranes ruptured and I have been here ever since! I am currently 30 weeks and 5 days! I pray daily. I also stay extremely still! I even eat lying down. So yes it is possible! Hang in there!

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I am still hanging on five weeks after my water broke. Still no measureable fluid and the baby is so squished in there they cant see the sex. Maybe next week. I would really like to name the little one. Otherwise, growth is on track, heart beat is strong, bladder is full, and he/she kicks like crazy everytime I eat.

Thanks again for everone's wonderful responses.

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