Premature Rupture of Membranes (PROM) and Preterm Premature Rupture of Membranes (pPROM)

I was laying in bed while I was 25 weeks pregnant with boy/girl twins, watching the evening news, when I felt wet “down there”.  I literally started giggling as I thought to myself, “I’m only 25 weeks pregnant and I’m already peeing my pants!”  I got out of bed, took my yoga pants off, and noticed it was a little more than the dribble I felt.  I walked to the bathroom where I sat on the toilet, stood up, and a huge WOOSH of water came out.  I knew right then and there that it wasn’t urine, it was fluid, and that my water had broke.  I called my OB and she told me to put a pad on and get to the hospital.  I told them that at this point we were beyond a pad, hung up the phone, stuck a towel between my legs, and headed to the hospital where they confirmed almost immediately via an AmnioSense strip test that it was amniotic fluid.  Looking back, I believe bleeding from a subchorionic hemorrhage or hematoma present with Baby A from weeks 9 until 17 deteriorated her sac and caused my pPROM.

Treatment and Risks

Unfortunately, there is no treatment for PROM or pPROM.  With PROM doctors feel that, in the majority of cases, it is safer for both the mother and baby to induce labor and deliver early.  However, some doctors may choose to put a mother on hospital bedrest and a non-stress test (NST) given daily to monitor the baby and ensure there is no distress.  Antibiotics are likely to be administered to ward off infection.  There remain different schools of thought, but PROM mothers are likely to face immediate delivery.

An ultrasound was conducted that showed Baby A, baby girl Keltie, had a broken sac and low amniotic fluid.  Baby B, baby boy Colton, had a sac still intact and both babies were not in distress.  While in the admitting room, they also found I was contracting every 3-4 minutes and I was immediately given a steroid shot (the first in a series of two) and started on magnesium sulfate to stop the labor.  I was put on strict bed rest where I couldn’t get up to use the bathroom or shower.  But, I was willing to do anything to keep the babies inside for as long as possible.  I had three goals given to me:  1 – make it 24 hours for the second steroid shot, 2 – make it another 24 hours past that to have the steroid series considered “complete”, and 3 – make it to 26 weeks gestation where the survivability rate goes from 50% to 75% for the babies.

I made it 4 days before Keltie stuck her feet through my cervix and sent me into full blown labor.  I was rushed in for an emergency c-section and on January 24, 2012 at 3:19am at only 26 weeks and 1 day gestation, I gave birth to two beautiful twins.  Colton weighed 1lb, 13oz and Keltie weighed 1lb, 9oz and both were 13 inches long.  After 100 days in the NICU, Keltie joined us at home.  Six weeks later and after 142 days in the NICU, her brother Colton finally joined us – that was the happy ending we were waiting for.  Today they are growing and thriving – to learn more about our story, please visit:  Project26WeekPreemies.