Premature rupture of membranes before 22weeks

[Amber1975]

Hi, first time on here so please excuse me if I seem like a novice, I am! I had my 20wk scan lay at nearly 23wks, my hubby and I were shocked to find out that the amniotic fluid had almost all gone around baby and due to shape of babies head plus growth retardation seems to have been gone for a little while! I have been strongly advised to terminate but decided against this and I'm now at 26wks. Been given little advice past the termination advice and wondered how many others have been through this and if any have resulted well.. Very scared but baby has strong heartbeat and pretty active!! ??

I have no idea but didn't want to read and run. I hope someone more knowledgeable will reply soon. Good luck to you and your baby x

How stressful. I'm sure we were told at our ante natal class that the amniotic fluid regenerates regularly.
Are they sending you to see a consultant or anything?

Yes have been to see two consultants and care will continue under one if them, they have written that they will conservatively monitor me but give no therapeutic intervention! Due for another scan tues and consultant visit Thursday need to prepare some questions to ask!!

Thank you xx

I'm glad you are being supported!

Sounds very stressful for you, made worse by the lack of positive advice... Did they say what the baby was measuring at, when you say growth retardation? Have they said if the amniotic fluid is starting to regenerate? When I was pg with DS1, I lost some fluid at 32 weeks, expected to go into labour but it did regenerate and the hole 'healed up', and I delivered at 40 weeks, 8lb4 healthy baby.

Hi thank you for sharing your story, that is really encouraging I have not been told that the waters could return and stay so that is really interesting!! Having made the decision now to continue u just want some more positive advice for how I can improve the situation. My other children were all born small and although this one seems to be just under the lowest centile it is continuing to grow but is just very small, I lost some of my water with my first pregnancy at 24weeks but had a show then this time I have not had a show or felt like the water has gone! I managed to get to 38wks with my first child and was then induced as they thought she would only weigh 3-4lb she actually weighed 5lb 2oz and us now a very healthy 16yr old. This little one has got less water and we don't know when it went so difficult to tell if lungs are formed enough. Baby moving around loads though xxx

I've had 3 of my pregnancies with PROM and every time i've been given steroids immediately and then scanned every 3 days to check fluid levels around the baby.

With DC1 they resealed and we managed to get to 38 weeks before induction but with DC3 the waters kept draining and i went into natural labour 10 days later and with DS i only managed 5 days as the fluid was very low and not regenerating so he arrived nearly 9 weeks early.

I can understand the Drs stepping back a bit when you were 23 weeks but your baby is now viable and like my last 2 Dc if your waters are still very low your baby probably has a better chance in an incubator than in you.

I would be asking for a plan of how far they will let you go and about the steroids. Have they swabbed you for Strep B and will they?

Can they actually refuse therapeutic intervention at 26 weeks?

Goodluck x

Thank you, will definitely be asking about the steroids now I think if baby is still surviving and more importantly growing surely there must be some kind of intervention they can now offer!! The most they have said is that they will try to get me to 34wks then deliver by c-section I will def ask about the steroids and swabs on Tuesday, hat I dontunderstand is baby is continuing to grow and pretty active just seems like they have written it off already, really disheartening!! Thanks for your help xx

I don't have any specialist advice or personal experience to offer, but will be sending the most positive vibes I can to you and the baby. Where there's life, there's hope.

Amber I know its not the done thing on here but i'm sending you a massive hug and hope you find the confidence to question what you are being told if you are not given satisfactory answers at your appointment. Ask what level the fluid is, they can tell you a rough measurement, i've got it on Ds's last scan report and can dig it out if you need to compare on Tuesday.

Ignore the negativity at the hospital and stick to whats important and thats how they are going to get your baby into the world safely without taking any unnecessary risks. x

Wow, I am so sorry you are going through this

The only thing I can suggest is getting a second opinion if you can. Depending on finances and location the Fetal Medicine Centre in London would give you some of the best advice you are likely to get.

Anecdote - a friend had PPROM at 26 weeks and hung on until 34 weeks and had a healthy baby girl. The leak never resealed, but with bedrest she kept generating enough water to keep her growing.

I have had PPROM at 18 weeks, the baby unfortunately did not survive. My understanding is that key lung development (surfactant) takes place after 22 weeks and that a level of amniotic fluid is essential for this. This is why some babies are unable to survive well outside, even though they are ok in the uterus, because their lungs did not develop.

There is a huge difference in outcomes between babies where the waters broke before 22-23 weeks and where the waters broke after this.

Having said that - it is huge that your baby is in there still after all this time, presumably no infection - most babies get an infection quite quickly with no waters and then the Mums go into labour. Maybe your waters replenished? They should now be able to tell you how much water is in there, e.g a measurement of the deepest pocket or they total it up into 4 quadrants - then you can ask them how much there should be. Since I lost my baby I have read news stories of babies where the waters broke at my gestation (but Mums did not go into labour) surviving and being born later. Perhaps their waters replenished though.

As others have said, you should have been given some steroid injections to help baby's lungs, and a course of antibiotics? It sounds like they are not communicating well so it is worth pushing for a meeting with the fetal medicine consultant at your hospital. You need to make sure that the hospital you are booked into has the right level of neonatal care available for very sick babies.

HTH - I really feel for you.

Thank you everyone for sharing, it so nice to get so e possitivity! I have also been told that the main factor is the lung development and wether my baby had enough fluid around it at the right time for the lungs to develop just enough!! I have spoken to a specialist at the fetal medical unit not in lond

Thank you everyone for sharing, it so nice to get so e possitivity! I have also been told that the main factor is the lung development and wether my baby had enough fluid around it at the right time for the lungs to develop just enough!! I have spoken to a specialist at the fetal medical unit not in London but on Bristol, this was three and a half weeks ago and he thought at the time that there was very little hope for my baby having said that the fax that I'm now 26wks must count for something this baby is obviously stronger than they thought. It has been really difficult for me to have total bed rest as I have other children and my youngest is a very busy two year old but when I can I rest I have been signed off from work and neglected the house so that I can try to get as much rest as possible. Kids definitely feel these changes have really helped and baby is always much more active when I'm led down with my feet up!! Great excuse to get kids and husband to do more too, thank you so much for all sharing your thoughts and experiences its so helpful and nice to know I'm not on my own my husband is really struggling and his defence mechanism is just to act as though I'm not pregnant which is tough sometimes xxxx

I hope your scan went well today x

Hi, thanks scan was good actually some positive news for a change, now have measurable pools of amniotic fluid and were a ble to see much more of baby, her heart is now filling less of the chest and is almost normal in size!! Baby has both kidneys and bladder had water in so is working. Just so nice to be able to see little one properly fingers crossed things will continue to improve. Hoping and praying xxxx

Brilliant news!

Fantastic news Amber

Make sure you discuss being swabbed on Thursday just in case you need anti Bs as a precaution x