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Premature birth

Connect with others and find premature birth support.

Second pregnancy after PPROM

29 replies

minipie · 11/11/2014 17:17

Evening all

DD was born at 34 weeks after my waters broke suddenly and contractions followed shortly after.

I'm now pregnant again, nearly 20 weeks. I've spoken to a consultant who says that as my cervix was closed when my waters broke, it's not a cervical issue, and as my waters went before contractions started, it's unlikely to be irritable uterus or oddly shaped uterus etc. Most likely explanation is an infection got in through the cervix and weakened the membrane. So, no reason to think it will happen again and they will treat me like anyone else.

Sounds good in theory. But then, if I google, I get a lot of stories from women who were told much the same, and then it happened again anyway.

So, my question is: did you have PPROM and then a subsequent pregnancy? What happened next time round? Were you given any extra monitoring or treatment (I have read about progesterone treatment for example, but mainly in the US)?

Just not sure if I should be pushing for anything extra or not...

Thanks

OP posts:
Dildals · 15/05/2015 16:40

Oh dear. Remind me, did they do a cervical length scan with you? I think you mentioned that they would like to do it at 20wks?

Good to hear you managed to avoid NICU. Hope you 2 are doing well! Congratulations! Were you already on maternity leave or did you leave your desk one day to simply not return :-).

I am 24 weeks now and due to have my last appt with the St Thomas prem labour clinic on Wednesday. Apparently they will be able to tell me with 99% certainty that I will NOT go in to prem labour, provided the scan and fetal fibronectin test come back positive (or negative, depending on how you look at it).

OwlFace49 · 30/09/2015 01:02

Same situation as you in my first pregnancy except my waters went at 31+3 weeks and DS arrived 32+2 after a super-fast natural labour. Definitely no infection present (swabs and urine clear plus have thankfully never suffered from a UTI in my life) and I don't fall into any PPROM risk groups so still don't know to this day what caused it because like you, cervix long and closed when waters went and stayed that way for 6 days after.

I had several bouts of "unexplained" vaginal bleeds after 20 weeks but that was the only indicator of potential prem arrival. A bleed at 27 weeks prompted them to give steroids (which I do think helped him no end).

This time round, I insisted on Consultant and midwife care under NHS at first antenatal appointment and consulted 2 private obstetricians prior to conception (am tight with cash but this is the one thing I wanted a few opinions on).

As you said, consensus really varies and "preventative" treatment for PPROM specifically as opposed to prem birth differs so much country to country. Mainly - in all fairness to the docs - because the reasons are so unclear if you're not in a risk group and don't suffer from infections.

I am currently 33+3 but have had a fraught time of it. I had a large (again - unexplained) bleed at 20 weeks and another at 21 weeks after which I was put on progesterone - cyclogest 400mg and recently doubled to 800mg (the theory being it will help prevent smooth muscle contractions which in turn may prevent "mechanical" rupture of membranes) and twice-monthly cervical scans by Consultant (although she herself acknowledged that this is a measure for preterm birth caused by cervical incompetence rather than PPROM).

I've also read a lot of studies giving mixed results for vitamin E, C and zinc supplements (the theory being they contribute to the production/strengthening of collagen in the amnio sac). Again, I checked for contraindications with Consultant and private docs and all seemed quite content there were none so started taking those at 20 weeks too. (Nb. There was some evidence to suggest too much Vit C early on in pregnancy can actually INCREASE chances of PPROM).

I also gave up work early, rested a lot more and drank a ton more water with this one. I wore a maternity support belt from the outset in the hope that it may help distribute the weight (just in case the amnio sac is weak for whatever reason)

I've also been super vigilant about UTIs and general downstairs hygiene and have avoided baths/swimming pools. I insisted the Consultant swab for bacterial vaginosis too (negative thankfully). I've also submitted urine to the GP every other week between midwife/hospital appointments to make sure it's clear. And have been super stringent with dental care as again, there is a link between gum infections and prem birth - not specifically PPROM though!).

However, despite all this, I have had a load of painful contractions since 30 weeks but they're definitely not Braxtons as they frickin KILL. Still no dilation or thankfully rupture so not sure what's causing them and I have opted not to have any more of the fortnightly cervical scans for fear they'll stimulate more contractions). I'm pretty content my cervix isn't the issue as the scans have always showed long, closed cervix and no funnelling.

I had a positive fFN test 3 weeks ago following suspected preterm labour (it wasn't - the contractions stopped after 8 hours) and so the doctors decided to give steroids and tocolytics just in case. Prior to that, I had 2 negative fFN's which, though not 100% conclusive, did give me some piece of mind.

I also had what I think was my bloody show yesterday so clearly this baby wants to arrive early but is so far holding steady.

So, in conclusion, I actually have NO idea if anything I've done has helped maintain my waters and this pregnancy or whether it is pure fluke that he's still in. However, I feel better knowing I'd done everything in my power even though it felt (feels!) like a lot of effort.

Sorry for super long post but as you can tell, this is an issue very close to my own heart!

Belleboo23 · 06/10/2015 11:21

Hi, I had my son at 35 weeks he weighed 5lb 4 when I was pregnant with my daughter I was told it would be one of those things and not to worry about early labour....she was born at 34 weeks weighing 5lbs both times my waters broke then followed by contractions and fairly quick labour's. 1st 8 hours 2nd 4 hours we are now trying for number 3 just hope they pay closer attention to my concerns this time xx

Chtaylor123 · 06/09/2016 14:07

Hi ladies,

Had my little girl at 27+3 after waters broke at 26+5 and was induced with suspected sepsis. I had cervical cancer 6 years ago and so was having cervical length scans every week and also internal visual checks to make sure my cervix was still tightly closed. General consensus was that all of these internal checks might actually have pushed bacteria towards my cervix, which then ate through the sack and broke my waters. Would have loved to have another baby in the future, but very worried that the same may happen again and we may not be so lucky this time. Has anyone else had a similar experience and did you go on to have another baby? Many thanks in advance :)

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