Pregnancy After PPROM

pregnancy

 

My first pregnancy was fairly normal up until the end.  I went into preterm labor and they eventually had to break my waters while I was delivering at 35 weeks.  My second pregnancy, however, was very different.  At 15 weeks I started having contractions and bleeding, I was told my placenta was low lying but other than that everything was normal.  At 17 weeks after carrying my two-year-old son around trick or treating, my water broke as I climbed into bed. I didn’t go into labor and switched to a doctor that allowed expectant management. I carried her for three more weeks until my cord prolapsed and I was induced.   Making the decision to get pregnant again was a big one that took four years to make. We didn’t have any answers as to why my water broke early last time and therefore didn’t know what precautions to make this time. I ended up making it to 30 weeks before my water broke this time. It ended in an immediate emergency c section as he was lying transverse and the cord was lying right on top of my dilated cervix.  A true miracle we didn’t prolapse again on our way in.  I had been dilated to 3 cm and 80% and contracting consistently for an entire week before it broke.  I was also starting to suspect that I may have been developing a BV infection but never made it to my appointment the next day to confirm.  I realize that it wasn’t a typical success story, but considering all of the heavy bleeds and bouts of preterm labor I endured.  My amniotic sac had to be pretty strong to make it to 30 weeks.  And as many of you would agree, I’ll take a 30-week baby with almost fully developed lungs over waters breaking when the baby is less developed any day.

1. Supplements:  For six months before we started trying and then the 6 months it took us to conceive I took many vitamins to boost up my system.

  • Prenatal- I used Garden of Life.  It’s a high-quality vitamin made with whole foods that I could take on an empty stomach. I loved that it contained ginger and probiotics.
  • DHA-  I used Nordic Naturals.  I recommend the strawberry flavored ones and they don’t get the fishy smell. They are made by a very reputable company. My son has been taking the kids version for years.  DHA has been shown to strengthen the amniotic sac along with preventing preterm labor among other great benefits.
  • Vitamin D- I used NOW It has been shown to reduce inflammation and therefore reduce the chance of preterm labor. I spoke with my doctor about the amount and he said it was hard to overdose so I decided on 5,000 iu’s. There is also vitamin d in my prenatal and in the DHA so I was confident I was getting what I needed. I felt this was especially important because the majority of my pregnancy was through an Indiana winter and now that I’m on bed rest and not getting much sun it’s important to keep up.  After taking it my entire pregnancy they checked my levels at 28 weeks and where I had tested deficient after losing my daughter, my level was now 62. They said that was great and not to change my supplement amount.
  • Vitamin C-  I usedGNC Soft chews  I had read conflicting articles on that had done studies on vitamin c used in pregnancies after pprom. Some suggested a high dose of vitamin c showed an increase in pprom and others said it helped.  I decided a daily low dose would be safe so I only took one soft chew a day. I hope this was enough to help fend off any infections but wouldn’t put me in the increased risk category.
  1. Progesterone- As mentioned in a prior post I did progesterone injections.  In the beginning of my pregnancy, my progesterone tested low and stayed low despite the injections until 16 weeks when it started to finally skyrocket upwards and then we lowered the injection dose.  My doctor doesn’t follow the typical 250 1x a week protocol and instead follows Creighton’s model.  See here.  I can’t vouch for how much it’s prevented preterm labor in the later part of my pregnancy but I did make it through the second trimester with my waters intact.

 

  1. Bi-Weekly Cervical Measurements-  Because my waters broke so early and unexpectedly, we were never given a true reason for why it broke.  One of the suspected reasons was an incompetent cervix.  I went in every two weeks for a transvaginal ultrasound to get a cervical measurement.  I sat at 3 cm the entire pregnancy until it quickly started shortening in the 3rd trimester from preterm labor.  Even though I didn’t end up having an incompetent cervix, it gave me and my doctor peace of mind throughout my second trimester.

 

  1.  Treating Irritable Uterus-  This is scary, stressful, and occasionally painful.  Some women contract constantly the entire pregnancy and make it full term.  I, however, was one of those women where irritability would eventually turn into preterm labor so it was important to keep it under control as much as possible. This is something you can discuss with you doctor and I plan on writing a post with all of my tips and tricks for treating it at home. I will update later.

 

  1. Support-  The most important this I did this pregnancy was found support.  I struggled with anxiety from the beginning of this pregnancy. I checked with our local hospital and it turns out they ran a small pregnancy after loss support group.  Getting up the courage to attend was life changing.  I made a few very close friends that have been by my side through all of the ups and downs of this pregnancy. It was so important to find people that completely understood what I was going through that I could laugh, cry, and grow with.  Even if your support is a group online, I highly suggest finding an outlet of support to get you through this scary but wonderful time.

 

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