Today was my last day of work for what may be an extended period of time. Next week I’ll be checking in to the hospital and I will stay there until the baby is born. The reason, as most of my close friends and family already know, is that my water broke extremely early in my pregnancy. I was 13 weeks and 1 day pregnant when it happened.
The condition is referred to as PPROM, or preterm premature rupture of membranes. Less than 3% of pregnancies are complicated by PPROM prior to 37 weeks gestation, and only about 1 in 1000 pregnancies are affected by a rupture prior to viability at 24 weeks gestation.
When the membranes rupture prior to 37 weeks, about 50% of women will go into labor within 24-48 hours, and 70-90% within a week. Those who do not go into labor are at an increased risk for an infection called chorioamnionitis, which can develop into a life threatening blood infection called sepsis.
Even though I have defied statistics and remain pregnant with a healthy baby boy over 10 weeks after my water breaking, doctors have given us a very grim outlook. Amniotic fluid is crucial for fetal lung development. Without fluid, our baby’s lungs will not develop and he will not survive birth. While amniotic fluid continues to replenish itself, it also continues to leak after a rupture. A low level of amniotic fluid, called oligohydramnios, is very dangerous. I have been diagnosed with anhydromnios, which means I have no measurable amniotic fluid.
Because lungs remain deflated prior to birth, lung development cannot be seen on an ultrasound. We will not know if our son has enough lung development to survive until after he is born.
So, as I mentioned in my first post, the odds are very much against us. Doctors discussed the option of terminating the pregnancy with us several weeks ago, but we have opted to remain hopeful and continue with the pregnancy.
Next Wednesday I will be 24 weeks pregnant, which is considered the date a pregnancy is viable. On that date, I will be admitted to the hospital for constant monitoring. I will receive steroids that may help with fetal lung development, and antibiotics that may help to prevent chorioamnionitis.
We are expecting to have a very premature baby sometime in the next few weeks. It would be ideal if we could hold out until 2015, or 28+ weeks gestation. My OB and fetal maternal specialist have already begun working with the hospital’s neonatologists, so they are prepared for the complications my son may be born with. Though the first major concern will be the level of lung development, there are also all of the other complications that come with prematurity. If he survives birth, he also has an increased risk of developing cerebral palsy due to the potential for chorioamnionitis as well as decreased oxygen at birth due to lung development.
There are also additional risks to my own heath. Infection is the primary concern, because if it were to develop into sepsis it could be fatal. Beyond that, I will most likely be having a classic cut c-section under general anesthesia. A classic cut means more blood loss and a longer and more difficult recovery for me. Any future pregnancies would be higher risk following a classic c-section.
Needless to say, this is a very stressful time for our family. We cannot express how much we appreciate all of the thoughts and prayers over the past several weeks. We have an amazing group of friends and family that have offered to help in so many ways. Thank you all so much.
I’ve also found a wonderful online support group with women all over the world who have had similar circumstances with positive outcomes. Their stories give me hope, and I pray that one day I will have a similar story to share. Thank you to those who have shared your experiences with me.
Please continue to remain hopeful with us. This baby boy is a miracle who has already defied the odds. Ultrasounds show that he has been growing and developing perfectly. He makes me smile every time he wiggles around in my belly. Every day I am able to remain pregnant, our odds improve, so every day I grow more hopeful.
I am looking forward to my hospital stay, because I know that is the safest place for both the baby and me. I will continue to provide updates on our progress while I am there. Look for the next update late next week after I’m settled in.