By Kendall, Denver, CO USAPPROM story #2.
PROM at 29 weeks + 2 days. Delivery at 29 weeks + 3 days.
Story added: 2011-01-31
My first PROM story was blue, but I’m happy to say that this will be a twin-green story! Over the past few years since our first PROM, I’ve read very many of the stories, both green and blue, and what gave me so much hope was to see that often a green story can follow a blue one.
My husband and I have been through 5 complete rounds of IVF. The daughter we lost was conceived during round one, then we didn’t conceive in rounds two or three, I miscarried at 10 weeks in round four, and we now have healthy boy/girl twins from round five.
I was a nervous wreck during this pregnancy, since I had a history of loss, and was now carrying twins, dramatically increasing the risks--- and I was 39 years old. Every week, my perinatologist exclaimed with pleasure that I was still pregnant. He kept telling me: “Try to get to 28 weeks.” The day we reached 28 weeks was such a happy day for us. Throughout the pregnancy, I did the following, which I think surely helped me to carry to 29w3d:
- I didn’t walk anywhere during my entire pregnancy, even to the mailbox at the end of my (short) driveway, and I was on very strict bed rest from week 21 on.
- I never took any tub-baths during the pregnancy, only showers.
- I used only unscented bath-soap and shampoo.
- I wore very over-sized, 100% cotton underwear.
- I tried to eat very limited quantities of refined-sugar-containing foods.
- I did not take the low-dose aspirin, typically prescribed for IVF patients.
- I took Femdophilus (a probiotic for vaginal health).
I strongly recommend Femdophilus. I’ve read several technical papers by Gregor Reid, the doctor who developed these strains of probiotics, and I was thrilled. This is a probiotic that was specifically developed for vaginal health. Typical probiotics are more-suited to intestinal health. If you are at risk for uterine infection (and if you’ve experienced bleeding during pregnancy), I would recommend taking Femdophilus. From everything I read, it is considered to be totally safe during pregnancy. Of course they may someday find that to be wrong, but at least for me, I’d say the risk of infection vastly outweighed any possible risk from the Femdophilus!
My previous PROM probably resulted from infection following heavy bleeding during my first trimester. Something the doctors often don’t tell you (so as not to scare you): If you bleed heavily during the first trimester, you are at significantly higher risk of complications later in the pregnancy even if you haven’t bled for months! I don’t want to scare people either, but I prefer to know what my risks are, and to follow the many guidelines suggested on the PROM-site, just in case.
I also think that the low-dose aspirin was a real problem for me in my previous, PROM pregnancy. For IVF, you have many blood tests to monitor hormone levels, and once I started the aspirin, at each blood draw, the phlebotomist would comment on the fact that I bled very easily, and didn’t stop easily. They would say “You’re obviously taking your aspirin!” Well, when I thought back, I realized that I finally stopped bleeding EXACTLY when I stopped taking the aspirin, at 12 weeks. In my two subsequent pregnancies, I didn’t take the aspirin, and only bled twice --- a vast improvement.
In this round of IVF, three embryos were transferred, and all three took, though during an 8-week-ultrasound, one appeared to be an empty sack. We feared that I would bleed heavily when that sack was lost within the next several weeks, but I didn’t bleed, and two weeks later, that empty sack had disappeared.
In this pregnancy, I had only two heavy bleeding incidents. One was an hour after my 6-week ultrasound, and one was at 20.5 weeks. Because the first incident was just after a trans-vaginal ultrasound, all ultrasounds after that were trans-abdominal, and I didn’t bleed after any of them. At 20.5 weeks, my bleeding was accompanied by cervical shortening and funneling, and I was hospitalized for a few days. A large clot of blood lodged at the opening to my cervix, and that probably caused, or at least worsened, the funneling.
1.5 weeks later, the cervical thinning and funneling had dramatically worsened and I was having some contractions, so I got a cerclage, and was discharged the next day. That was terrifying, because it was touch-and-go for the week after that, to see if the cerclage worked out, and ironically, if it didn’t, I would likely deliver at about 22w5d, exactly when I delivered our daughter whom we lost.
We were fortunate that all went smoothly from 22w to 29w, though the blood clot never disappeared. I was on strict bed rest, but all went well. Then at 29w I failed the sugar test, and that, in combination with some other signs, convinced my perinatologist that I would deliver sometime in the next two days to two weeks. Luckily, he had me receive the two steroid shots, 24 hours apart. The evening after the second shot, my water broke abruptly as I lay in bed. No question about incontinence this time, baby A’s sack broke and I drenched the bed. Because contact with blood can weaken the sack , my PROM was probably caused by the large blood clot that had formed at 20.5 weeks, and remained wedged between my cervix and baby A’s sack for the subsequent 9 weeks.
I went to a downtown Denver hospital, St. Joseph’s, where they have a high-level NICU. They started me on antibiotic IV, and said I’d see my perinatologist the next morning,-- no rush, since the twins sounded good, and contractions were minimal. Then a few hours later I began bleeding heavily, the contractions got worse, and baby B was not tolerating them well, so they performed a quick c-section. I delivered 14 hours after the second steroid shot, at 5am on New Year’s Eve.
Our daughter, baby A, was 2 pounds, 12 oz. Our son, baby B, was 3 pounds. They did very well in the NICU, and came home earlier than expected. Our daughter came home at 36 weeks, and our son came home at 36w6d. They are now 13 months old, (10.5 months corrected age); they are at 75th percentile in weight for their corrected ages; they are doing all of the things that they should be doing, and they are terrifically healthy.
I am still stunned that I carried them as long as I did, and that they are healthy. The 7 weeks in the NICU were stressful, with one bad scare, but the nurses were terrific, and it was a positive experience overall, watching our twins grow and become strong. They had distinct personalities right from the start, as little 29-weekers, and while those personalities have, of course, developed tremendously since then, we can still see “the same kids” whom we cuddled at 3 pounds in the NICU.
My heart goes out to any of you who have also lost a baby, and to those trying to carry a high-risk pregnancy. My two cents: I found I would get depressed if I thought “I want to make it to 34 or 37 weeks, or such” because that seemed so impossibly far away. In fact, even 28 weeks seemed overwhelming until about 27w5d! I found I felt much better if I just hoped for “one more day, every day.” Even before viability, I tried not to think: “Tomorrow isn’t enough.” I just thought, “one more day, and then maybe one more after that…” and so on.
Over the past few years, I’ve done a lot of reading about first trimester bleeding, PROM, and IVF/fertility. I’d be happy to speak with anyone who’d like to discuss what I learned.
Very best of wishes to you all.