PPROM Update #5 - 27w4d

I had my 5th doctor visit today since rupturing. It was another good visit on the whole.

Baby was active and even showing lung movement on the monitor. I did actually see it this time, although I'm not sure I would have known if Dr. M wasn't narrating. Again, lots of fluid in the stomach and baby remains vertex. (Honestly, I'm not obsessed with having another VBAC, but I wanted to know what the stipulations were for having one, since we'll obviously be delivery preterm. I did ask and was told that, since baby is vertex, we would go ahead with a vaginal delivery at this point. Obviously, there is never a guarantee, but, since baby is no longer breech we are looking good. Should have asked, but I don't know at what point a breech vaginal becomes an option. We'll just keep baby head-down!)

I was also informed that I passed the test for gestational diabetes - Hooray!

A few worrisome items: Not sure if baby's SUA is coming into play or if it's more a factor of the 14day +/- margin of error, but Dr. M seemed a little surprised at baby's short femur length again. His abdomen is also measuring small and baby has only gained 1 oz. in the past week, now measuring at 1 lb. 10 oz. However, as he HAS gained and has shown a short femur since his first growth ultrasound, I'm not going to get worked up about it. At this point, there is nothing we can do anyway. Dr. M didn't seem overly concerned, so we'll just check again next week and hope that baby has even better measurements and a sudden growth spurt!

For those who have asked or been wondering, the reason the membranes cannot be sewn back together is that the membrane is only about the thickness of 2 sheets of paper. In order to sew them back together, one would have to poke more holes. Some studies have shown that it is possible to patch a small hole, but that is normally when the rupture is caused by doing an amniocentesis. In those cases, the hole is small and the doctor has a pretty good idea of where the hole is. In my case, however, since I gushed, there isn't just a small hole so that's a no-go for us. There is always a risk of infection in doing anything. Apparently, there are researchers out there trying to find a solution to this problem; there are also some studies being done using egg whites, but, so far, these have been limited to animals. Interesting thought, although I wonder how long the egg whites would be able to remain intact.

It seemed like a little bit of a slow day today - one of the ultrasound technicians even told me that a number of her patients weren't showing up, so she was harassing the front desk (I've seen her before and she knows my story, so we got to chat a little bit) - so it was nice to be able to get to ask more questions and not feel like I was putting everyone behind.

One of my other questions was in regard to how fast I could anticipate labor to be. A few stories I've read online and one of the triage nurses told me that things can progress pretty quickly. However, in talking to Dr. M, it was reassuring to hear that, on average, when a woman goes into labor and has her water broken, it reduces labor time by only 2 hours. Considering that it took me 6 hours to get to 5cm the first time and about 8 hours to get to that point after my water broke the second time, that's a relief to hear. The way some people were talking, it seems like baby will be out in about 5 minutes once the contractions start! Definitely do not want to deliver this baby at home. (I admire those who can, but if he needs specialized care or we require any surgical help with delivery, I would much rather be at the hospital!)

Once again, the topic of hospitalization came up again (I didn't bring it up this time!) and, really, he said that women in the hospital get the same thing I do - daily NSTs and weekly ultrasounds. In addition, however, they do get woken up early - say 4am every morning - to have their vitals checked and then they just get to lay there by themselves for the better part of the day, usually seeing the doctor once later in the afternoon. However, most women start going stir crazy pretty fast. He admitted that it's nicer for him to have patients in the hospital because then he knows where they are and what's going on but, since I have a husband and three kids at home, he has felt, and I agree, that I am much better off at home. I have only met one online friend who fully supports me staying at home and I so appreciate it! I think most people tend to think that what was best or what worked for them is best for everyone. Maybe, but I really don't feel that that is the case for us.

My last question was to know if Dr. M has had any other patients that ruptured about the same time I did make it to 34 weeks and be able to take their baby home. His answer made me feel so good. He didn't hesitate at all, just shrugged and said, "Oh yeah." While it's occasionally nice to be the original pioneer, I am soooo glad to hear that it has been done before. It just gives me all the more encouragement that our little boy can be born perfectly healthy in 6.5 weeks and come home with us!

Yes, no typo - 6.5 weeks. We will hit that magical 28-week mark this Sunday. Believe me, we're going to be celebrating this one bigtime! (Okay, so probably just ice cream cones all around since I can't go out and it's Sunday, after all.) Twenty-eight weeks is the point where baby's chance of survival hits 80-90% and odds of baby having problems resulting from prematurity drop to about 10-20%. Obviously, we want to go much farther, but just getting to 28 weeks will be a HUGE relief!

As we do each day, thinking of all of you who continue to pray for us, bring dinners, watch our kids, send phone calls and emails and leave positive comments. Thank you all!

Also the deepest, sincerest thanks, admiration and appreciation to my mother-in-law who has now spent 5 long weeks with us taking care of all of us, the house, the laundry, the dishes, food, dresses for our girls' to attend my sister's wedding as her flower girls...

Mom, we love you and cannot even begin to thank you for all you do for us! Thank you, thank you, thank you!!!