By Paula Johnson, Gurnee, IL USAThis was our second twin pregnancy after a previous PPROM loss at 19 weeks and a result of our fourth IVF transfer. Because of my previous loss, I had a cerclage placed at 13 weeks and was on bedrest at home from that point forward. I also had weekly cervical checks, which went well until I hit 25 weeks.
PROM at 25 weeksDelivery at 26 weeks.
Story added: 2003-08-11
At that appointment, I was told that I was 1 cm dilated and 50% effaced, and the OB wanted me to go to labor & delivery for monitoring. Once there, we found that I was having some uterine irritability and mild contractions, but nothing that was too alarming. The OB was ready to send me home, but my perinatologist wanted to keep me overnight. Good thing, because my water broke later that night. I was officially confined to bed for the remainder of my pregnancy.
We already knew we were having two girls, which I was told over and over played in their favor. They gave me a series of steroid injections to help mature the babies' lungs, put me on magnesium sulfate to prevent labor and antibiotics to ward off infection, and sent a neonatologist to talk to me. He said my babies would have about an 80% chance of survival if they were born immediately, and every healthy day in utero made their chances greater. If they survived the first 4 or 5 days, their odds would go up to the high 90s.
We managed to hold off labor for one week. A point of contention among the many great doctors caring for me was the cerclage. Leave it in and risk infection, or take it out and risk instant dilation and a sudden vaginal delivery? It turned out to be a moot point, as I spontaneously went into labor the day before the cerclage was to come out.
An ultrasound was performed and we found that the babies were transverse, lying one on top of the other. To minimize the trauma to the girls, the OB decided to do an emergency C- section with a vertical incision instead of the usual bikini line incision. I was wheeled into the high- risk delivery room at 6:15, and my daughters were born about 45 minutes later. Olivia Renee was born at 7:02 pm, 1 lb 15 oz and 14 inches long. Cassandra Faith was born at 7:03 pm, 1 lb 12 oz and 13.5 inches long. They were both whisked off to the NICU, where their little lives hung in the balance for most of the first month. It turned out that I had contracted an E. coli infection despite the antibiotics, and Olivia (the twin with the ruptured sac) was very sick.
Our story has a happy ending, though. Cassie came home after 98 days in the NICU, one day before their official due date, and Olivia followed two weeks later after 112 NICU days. So far, it looks like they may both escape some of the most serious consequences of extreme prematurity, although we won't know for a long time. They are now four months old (one month adjusted) and doing great at home! Paula's PROM Story