Hospital wants to send me home after PPROM. I don’t want to go. Help.

[CatsEye99]

Posting for traffic. My waters broke at home and were bright red, and I was 26 weeks with DCDA twins. I called an ambulance and was rushed to hospital where I had a huge gush of red fluid. I was counselled about preterm birth and given steroid injections. I saw a neonatal doctor who stated the most important thing was to deliver at a hospital with NICU cots.

Despite severe agonising pain, a week has passed and I haven’t given birth. Twins aren’t distressed and my observations are fine.

However I feel incredibly unwell. I keep burning hot and turning red but my temp is not raised. I feel like I have the flu or another illness. I have no energy and can barely move due to pain. Codeine won’t touch it. A midwife told me to have a hot bath which I am sure is contraindicated.

The staff want to send me home. I have stated I do not want to go home due to me living an hour from the hospital and the risk of infection, cord compression, preterm delivery and stillbirth. I do not want to lose my babies. I want to remain in the unit with NICU like the doctor advised.

Can anyone give me any advice? I can’t find any info on this anywhere and feel like the staff are fobbing me off.

I suspect it's early labour but keep getting told it isnt because theres no dilation. I have told them historically I have never dilated but they don't think that matters.

I think this is the issue, that they don’t usually keep women in early labour in hospital indefinitely. But because OP is quite a distance from the hospital with NICU beds she wants to stay until full labour starts. It’s already been a week though so certainly not a short wait!

I wasn't dilating at that stage either (well, I was 3cm dilated from a weak cervix but that was a different issue). I wonder if it's just a question of semantics - I never actually asked if I was in labour, but I do remember asking the consultant, essentially, if there was any rowing back from this point, and he said no, it would continue and eventually kick into active labour. The contracting was the process leading up to active labour, if that makes sense?

If you’re feeling strong enough I personally think it’s time to speak to the chief of midwifery and/or the clinical director. Just ask to speak to them urgently and they should come and see you.

I’m a healthcare professional and think your care has been disgusting.

Try and stay as relaxed as possible (very difficult I know)

Caprisun I know, the question was about whether there was anything actively sinister going on - over and above the going into labour at 26 weeks, I mean.

I should say op that I did have a raging infection (chorioamnionitis) by the time Ds was born. I don't know when that kicked in though and if it was related to the cobtracting as they hadn't been checking my CRP

Either way I agree with Maldives, they need to be checking you out again!

Have you contacted PALS yet?
That would be my next step, it sounds to me as though you're receiving very poor care and oversight.

I'm sorry, I haven't read the whole thread as something very similar happened to me over the summer with DCDA twins and sadly it didn't end happily (and I went six weeks without labouring then when it did, it happened completely out of the blue and proceeded very quickly- am not saying that to terrify you but I had been blasé about it given I wasn't in labour, and it really shocked me when labour kicked in very quickly in a matter of hours). However are you aware / has anyone mentioned the Little Heartbeats PPROM facebook page? It is very helpful in advising what you need to look for in cases of PPROM.

I wanted to stay in hospital because of the infection risk, and I did. PM me if you want - my waters broke at 20 weeks and I went into labour at 27 weeks, unfortunately my babies didn't survive as their lungs didn't have chance to develop. Yours will stand a far better chance at 26 weeks as lung development mostly happens before this, so I hope you have a happier outcome than we did. But I would definitely push to be in hospital, and look up that FB group as it is helpful re guidance about best practice post PPROM. Good luck

This group: m.facebook.com/groups/721865707845818?ref=m_notif&notif_t=group_activity

And I'm sorry if I'm repeating anyone or not up to speed with the whole thread.

Rosti

I will have a look at that group. My mum has been in touch with PALS I think.

I'm now bleeding red again.

Cats - I cannot believe the way they're treating you!! It's absolutely outrageous.

This might be a completely stupid question but have they checked your hormone levels? Hormones can cause hot flushes and could be making things worse.

This is probably a really stupid question but what happens if you labour but don't dilate?onviously in a full term pregnancy this is a failure to progress and certain measures are taken but if you're very very early on like you are, OP then what happens?

Can't offer any advice but wanted to offer another hand to hold and to send you kind thoughts

@CatsEye99 I would get someone to physically walk to the PALS office and demand a crisis care meeting. There's no joined-up thinking in the approach to you and you're constantly being given incorrect and conflicting information.

I had DD2 at 27 weeks via EMCS and whilst traumatic, I was prepared for what was going to happen and understood the process. I still have PTSD. The way you're being dealt with is shocking and not acceptable

Remember exactly! That is my fear. I got to the massive half a centimetre at 37 weeks with my son and had him by cesarean at 38.

I am so sorry that you are going through all of this @CatsEye99.
I know you may not feel up to this but you have to keep going higher and higher in the chain here. It seems not far from negligent that they are just ignoring what sound like terribly worrying symptoms.
Tommy's the baby charity have a midwife helpline. They are really lovely, I rang them to discuss a few things. They also have contacts and give you the right idea of what words to be saying to people in order to get heard. I know that individuals are under extraordinary pressures due to NHS problems and lack of funding but this is too serious to just accept.
www.tommys.org/pregnancy-information/about-tommys-pregnancy-information

This level of care is shocking. I hope your Mum got some good information from PALS.

In fact, I'm struggling to even call it care. Neglect, more like. Especially from some quarters.

Have they even done the repeat bloods or the scan yet?

I might almost be tempted to call for the head of midwifery and tell them that your "care" has been so dire that you are virtually about to initiate the complaints procedure.

Keep pressuring them. Seriously, I'm afraid that it really can come down to "he who shouts loudest" in these situations. Not ideal of course, but that is how it often works.

I've had the bloods done now. They're trying to sort the scan but the scan people keep saying they are full. I asked why can't they cancel or delay a routine scan to do my emergency one, because if roles were reversed I would happily wait longer so someone in this situation could get seen, but been told they won't do that.

If it's early labour but no dilation there is nothing extra to do at this gestation. It's not the same as a full term pregnancy. As long as there's no infection the babies are best off in utero, with occasional monitoring to ensure fetal wellbeing as much as is possible at 27 weeks. Standard care would be regular pulse/BP/temp & twice weekly bloods for infection markers (although should be repeated today if you're feeling flu like, although I think you've felt like this since bloods were last taken?). The bleeding could be due to cervical changes, or could be related to underlying infection which your observations and the blood results could help determine. Although they should be more helpful with pain relief, this situation is essential watch and wait. I appreciate that's frustrating, but delivering your babies earlier than necessary is not in their best interests.

Wouldn't the babies get distressed if its labour but not progressing? My son pooed in the waters because of it. I had had loads of monitoring and no one realised...

No, not necessarily. Preterm labour is a completely different thing to term labour and can't be managed the same way.

Yes I completely agree if pals have done nothing by now defo the head of midwifery or the clinical director

Hi everyone we have sorted it!

The matron came to see me after my mum had rang up and spoke to people, and she got a consultant back up to see me.

Consultant thinks I have a tear in twin 1s placenta. I have risk factors for this and it explains the pain and bleeding. She thinks biggest risk is an abruption and has explained that will mean a crash delivery.

She's said I'm absolutely not to be discharged and am to have CTGs, regular scans and that if I am in any pain they need a prompt response. Shes updated this in my care plan.

Shes also told me not to expect to go past 30 weeks as its likely either I'll get an infection or the placenta will tear further both of which would mean I'd need to be delivered

I feel so much better now I know what is happening.

I'm so pleased you've finally had an answer. Keeping my fingers crossed for you.