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Author Topic: PPROM x 2, expecting again!  (Read 3567 times)

crashta

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PPROM x 2, expecting again!
« on: December 08, 2013 at 03:40 PM »
In April 2009, our first daughter came too soon at 23.5 weeks due to PPROM.  I was leaking small amounts of fluid for about 5 days before an infection set in and I went into labour.  GBS was present in the autopsy of both my placenta and the baby.

In August 2011, we discovered an empty sac (blighted ovum) at 12 weeks.  Seemed like a hysterical pregnancy as my body never figured it out, I had a D&C.  Our pregnancy in April 2012 ended as a regular MC at 7 or 8 weeks.

And most recently (June 2013), our second daughter was born at 19 weeks again due to PPROM, this time a full rupture of my membranes.  To complicate the birth, the cervical cerclage that was in place at 13 weeks had to be removed.

Without trying, we conceived again at the end of August and the baby is due May 2014.  I have had one tele-conference call with a Perinatologist, the same day I took pregnancy test!  The appointment was supposed to be pre-conception counselling only I am already PG!  Had we not gotten pregnant so soon, the specialist would have recommended a biopsy of my uterine lining to check for infection as well as an ultrasound/exam to determine the shape of my uterus.  She does not believe that either of the PPROM births were due to an incompetent cervix.

To complicate things, group B strep is colonized in my body and I am convinced this is directly related to both PPROM..  The specialist however, and others on her team do not believe that I should treat the GBS throughout the pregnancy.

So, for this pregnancy I've started vaginal prometrium, 100mg, and go for regular endo-vaginal ultrasounds.  However last week at 16 weeks, my cervix length was 2.6cm and the technician saw some dilation.  Because of this I was put on precautionary bed rest and have a follow up ultrasound this Tuesday (17weeks).  I am truly hoping for modified bed rest but am happy to have found this site.  Your stories of 'keeping them cooking' give me hope.

Thanks for reading! ~ Amy


jodibainum

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Re: PPROM x 2, expecting again!
« Reply #1 on: December 08, 2013 at 07:49 PM »
Wow, you have been through a lot.  Keep us posted.  We are here to support you any way we can!  Monday is Roll-Call...just to check in and see how everyone is doing!  Tuesday there is a chat at 2pm Eastern.  Just a couple of things to keep you busy! 

I was on bed rest for 13 weeks due to incompetent cervix...received cerclage at 22 weeks.  I was so thankful for this site!

andi-pants

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Re: PPROM x 2, expecting again!
« Reply #2 on: December 09, 2013 at 07:21 AM »
wow, you are so strong to have gone through all that! I am so very sorry for your losses. I was group B strep positive, so was a friend of mine who was due two weeks after me. I went into preterm labor 4 times during my pregnancy but managed to hold on until full term. My friend had pPROM at 30 weeks and held on until 32+4 before delivering her son, Caiden. He is happy and healthy now but both my friend and I wonder what our pregnancies would have been like if we were tested and treated for the group B strep before going into labor and pPROMing. Maybe you can seek a second opinion about getting treated? I'm really not sure it would make a difference, but it wouldn't hurt (as far as I know).

crashta

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Re: PPROM x 2, expecting again!
« Reply #3 on: December 13, 2013 at 07:26 PM »
I got to speak with the perinatologist this afternoon!  He has downgraded me to part time bed rest!  Max 4-5 hours on my feet total in a day and I can be sitting or laying down otherwise.  Good news for the custom orders I have waiting to sew(baby quilt & nursing cover).

He does however have a different opinion regarding my cervix and doesn't agree that it is dynamic (as reported by the radiologist who documented this week's ultrasound).  Sheesh, just when I thought I had an answer for something, I don't. 

The plan for now is to double my progesterone to 200mg daily; continue part time bed rest; have a follow endovaginal ultrasound next week and every 2 weeks there after.

He also recommends that we consider me moving to the lower mainland (Vancouver, BC) to be closer to the maternal/fetal medicine ward of our BC Women's & Children's hospital.  I live in northern British Columbia and although there is a NICU ward 3 hours away from our community, it is not equipped for babies born before 28 weeks.  Which seems a lifetime away when I am only 17w3d now.

In the meantime I'll stay put on the couch and in bed as much at it takes to get this little on as close to term as possible.  :)
« Last Edit: December 13, 2013 at 08:08 PM by crashta »

Eleanor Rigby

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Re: PPROM x 2, expecting again!
« Reply #4 on: December 14, 2013 at 12:20 PM »
Sounds fairly positive if you've been downgraded to only moderate bed rest. You must be very relieved. Is moving to Vancouver an option for you?

I'm Canadian as well (from Calgary) but I live in Germany now and always wondered what the care would be like if I were going through this in Canada but it sounds like you're in good hands there and they are seeing you regularly. Will you go for another cerclage?

crashta

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Re: PPROM x 2, expecting again!
« Reply #5 on: December 16, 2013 at 02:29 PM »
I have a brother and SIL in North Vancouver but they live in pretty small condo.  They don't actually know that we are pregnant, in fact, only my husband's brother and wife know outside of our friends and co-workers in Burns Lake where we live. This being our 5th pregnancy in 5 years, it's just too hard to tell our parents and family only to have un-tell them when disaster happens.  So far, I've the pregnancy off facebook, so unless someone sees me in person, they don't know!

We are definitely thinking that I will go to Vancouver until the end of February.  Then be in either Pr. George which has a NICU ward or back at home as PG is 2.5 hours away.

As for the cerclage, yes, if I get between 11-14mm than I will need a rescue one.  I truly hope that the now doubled progesterone is doing it's job.  I worry that another stitch will just lead to infection and another PPROM delivery.


crashta

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Re: PPROM x 2, expecting again!
« Reply #6 on: December 25, 2013 at 03:43 PM »
Well my follow up EV scan last week showed my cx at 1.4cm and beaking.  I spoke to the perinatologist Thursday morning, packed up 2 suitcases in the afternoon, left for Pr. George as much of BC was under a snowfall warning and flew to Vancouver Friday afternoon.

Saturday morning I had my rescue cerclage... it went well.  Spent the rest of mostly sleeping.  Was up and mobile Sunday and Monday.  The ultrasound on Monday afternoon was awesome, my cx was 3cm, closed and showed no beaking!  Cx surgery = success for now!

I transferred to the Easter Seal house near the Women's hospital yesterday (Christmas Eve)... pretty emotional as I was alone.  My husband is back home with our house and cats.  It isn't realistic for him to be here with me from now until March when I get to 30 weeks.  I am spending Christmas day/evening with my younger brother, SIL and her mom.  And luckily I do have colleagues in Vancouver as well.

I'm still on MBR for now.  I have a follow up appointment on Dec 31st.

Merry Christmas to all of you!

Eleanor Rigby

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Re: PPROM x 2, expecting again!
« Reply #7 on: December 27, 2013 at 07:19 AM »
That is wonderful news, it sounds like the cerclage it doing its job!