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.

There might be a hint of meconium on that pad. It can be a subtle change of colour at first, building up to a definite one. That is how it was with me when having DD3. YOU feel it has changed, so they should take it seriously. You need to insist on seeing a senior ob/gyn doctor, and you MUST refuse to go home.

This treatment of pregnant women and their unborn babies really isn't good enough. Don't accept it.

My waters have been a definite red until this point so it's very different.

Still waiting for the doctor.

i would start making more of a fuss over the pain.

Hi OP,

I think you should stay where you are as well and maybe think about contacting an advocate service in case you become more unwell. All of the advice I've read for PPROM states NOT to have a bath because of the infection risk, so I don't know what they're thinking of telling you to have one. My waters broke at 34 weeks and I had to beg to be let home - and I wasn't in pain like you are.

Good luck and I hope you get to see a consultant soon.

The brown looks like "old" blood to me as opposed to the brown/green of meconium. I absolutely wouldn't be going home though!

The people on this thread who are assuming that this is a purely medical question and if 'the doctors' have decided OP can go home, that must therefore be correct, are talking dangerous nonsense. She is not at A&E with a cold or a sore finger, she's got 26week twins and PPROM!!!!! That's a hugely high risk situation for infection and fast preterm labour, it's not comparable to someone who got told to go home and wait for labour at nearly full term!! It might be that the OP is medically well to leave, but on the face of it, it really doesn't look like it. Poor medical decisions about discharge get made all the time because of poor communication and pressure from managers about beds. OP you need consultant review and if need be PALS intervention. Stand your ground.

As for c-section vs natural birth, I had a 26 weeker and the consultants were all unanimous that other things being equal a natural birth was better for the baby if at all possible - and definitely better for you, as a c-section so early is a high risk in itself. I don't know how that plays out with twins, mind.

Thank you everyone. They keep acting like I am demanding and being precious so I appreciate the reassurance.

The pain is horrible. They've told me they can't do anything about it

Have you had any contact with the charity little heartbeats at all OP?

You’re not being precious OP. I really really feel for you, it’s an awful situation which I have been in too. I was treated like shit and it turned out my instincts were right but it was too late for one of my babies.

Are you in the labour ward? They could give you gas and air.

Given your distance from hospital, the unexplained pain you are in, and how bad you feel, it makes completely sense that you would want to stay in hospital.

"Can a consultant please put in writing that, despite my unexplained pain, living an hour away from hospital, and still feeling flu-ey, you are completely confident it is safe for me to be discharged?"

Definitely get checked for sepsis, given your symptoms, and make sure they put in writing in your notes that you have the all-clear if they are confident of that.

If they insist on discharging you, make sure that you get them to write down in your notes all of your concerns and that the discharge is against maternal wishes.

I don't think you are being silly at all. You might also remind them that you are a second-timer and you do have a three year old at home, so it's not as if you would want to stay in hospital unless you felt it was serious and necessary!

I'm with frogsoup all the way. This is an extremely high risk situation.

However, i had a 28 weeker who was extremely growth restricted due to iugr (size of a 24 weeker). All my consultants were unanimous that a c-section was the only way forward and the baby wouldn't survive vaginal birth. So i guess, every case is different and you need your obstetrician to explain clearly what will happen to you and why.

Sending best wishes, strength and

Op have you seen the little heartbeats Facebook group for pprom? My friend who had the same found it really useful for advice. Sending you what a stressful time for you

You can try contacting Birthrights by email; it's possible that they may have advice.

Or AIMS, who have a helpline:

www.aims.org.uk/about-aims

With DCDA twins, c sections have marginally favourable outcomes statistically for the babies over vaginal birth, but it is negligible. There’s obviously a lot of other factors here, not least that it’s very early.

Twin pregnancy is a very different ballgame to Singleton pregnancy and unfortunately not every obstetrician or midwife is highly knowledgeable about twin pregnancy / birth.

OP, I’m trying to find a local MVR for you and will send you details if I get any.

Also, you might consider phoning the TAMBA helpline if they do send you home to gather some info on risks with these issues and a twin pregnancy, they might have some studies you can give to the obstetric team.

No I haven't I will have a look.

Thank you. I feel like they are treating me as if I have just minor issues when this is a very serious problem :( I lost three babies to early losses in between my son and these twins and I am terrified it'll happen again now.

Thank you SinkGirl.

Ok, you need to be in hospital. I don’t want to scare you but you’re leaking, high bp and in pain. I don’t know what to suggest, you must be so scared and frustrated. You need to be in hospital. I’m in west drayton, if you’re anywhere near and could use a visitor more than happy to pop in with grapes and trashy magazines if you like

I can't quite believe how dismissive the midwives are being, given your medical history and current circumstances. Really hope you see the doc soon. Sending hugs & hand hold

I've had some really good midwives who have been helpful. One told me to call her any time I was worried and she would listen to me and get a dr if needed.

The ones on today however are rubbish. They aren't listening at all and seem to think I'm just being dramatic.

Also you state no one knows what to do as this is so unusual - that is not the case at all,this is actually not an unusual event and it is usual protocol for the patient to go home after a period of monitoring. The usual process would be to return for scans and bloods 2 or 3 times a week and for you to monitor your temp at home for signs of infection.

This is good info. OP who told you this was a really rare medical event? I can’t help but feel part of the reason your anxiety is so high is because you’ve been led to believe by someone (staff?) that this is a really unique situation that staff have little experience with. Anyone would be stressing out believing their specific situation was rare and therefore their clinicians were inexperienced in it!

The people on this thread who are assuming that this is a purely medical question and if 'the doctors' have decided OP can go home, that must therefore be correct, are talking dangerous nonsense. She is not at A&E with a cold or a sore finger, she's got 26week twins and PPROM!!!!!

To be fair, I do think people reading and responding have managed to read the OP and are fully aware OP doesn’t have a broken fingernail the info is all in her post. The only people who have access to OP’s current medical stats are her healthcare team, not us here on MN (who aren’t medics or, if we are, would be very unprofessional to try and diagnose over the internet!). It seems more dangerous to me to act as if the healthcare team haven’t a clue what they’re doing (despite the fact they’ve had OP in for a week already and have been monitoring her) as they know far more than us and it’s unfair to OP to fan the flames of her anxiety with such an overly dramatic approach like this.

I lost three babies to early losses in between my son and these twins and I am terrified it'll happen again now

I’m so sorry for your loss your anxiety and terror makes perfect sense in light of what you’ve been through. Have the hospital offered you any maternal mental healthcare or to be put in touch with the mental health team? If their assessment is that there’s nothing to be seriously worried about currently (which is a good thing!) and they think you’re just being anxious i would hope they take that anxiety seriously as they would any other illness and offer you some support.

The midwives at our hospital were insisting on sending me home 10minutes before I gave birth to my first at 38+6. Luckily we didn't listen and pushed back but I almost gave birth in the DAU waiting area.
Please continue to be your own advocate and insist on speaking with a doctor. I honestly cannot understand why they would tell you to go home under the circumstances.

I can't believe what I'm reading here. You need to be in that hospital OP.

Wishing you well

That's so frustrating! Can you call the helpful midwife for advice?

Have a Google for the RCOG information sheet. Although that says you can be monitored at home it clearly states if you are in pain or feel flu like symptoms you should seek medical advice. Until they have addressed these symptoms properly I would be very reluctant to go home, especially given your last bloods were 2 days ago.