24 weeks + 5 days, 8 weeks post rupture, day 9 at my parent's place. I'm sticking with my ovulation date at this point. Screw doctor's dates.
Doctor's appointment today. Slept poorly last night at the prospect of leaving my safe little cocoon to go sit in a waiting room. I worry about what the doctor might say to crush our spirits a little more and I worry I'll leak a lot, or bring on cramps or labour being up and about. And the appointment was for 8 am so it means I have to get up early! I don't do well with early mornings.
Anyway, the appointment was first. Dr. S. could fill in for Eeyore in Winnie the Pooh if the job ever becomes available. He's such a downer. He basically said that while it was 'good' that I'd made 24 weeks (longer than last time), we are still looking at a very poor outcome because of how long my membranes have been ruptured. Yeah, thanks we know, Eeyore. I worry about this on a minute to minute basis, you don't have to remind me. Then we asked about getting me a private room at the hospital. He basically said that infection risk was not a good enough reason. When we told him I couldn't sleep due to the anxiety and stress of the situation and having a roommate made it worse, he said he'd ask the hospital administrator if 'anxiety' was a good enough reason, but that he wasn't very hopeful. So then I flat out said "well then I can't be hospitalized. It's just too stressful". I hope he understood how strongly I feel about this. It's pretty serious when your pregnant high risk, congenital cardiac patient is refusing hospitalization. Maybe he'll push on my behalf...being a well respected, high powered OB has got to be good for something.
Our alternative plan at this point is using my insurance to pay for a private duty nurse to come and stay with me during the day while I live at my parent's house. My mom has to go back to work next week and I'm afraid to be alone during the day. My doctor said he would sign any paperwork I need to get this in place if that's what I wanted but he didn't feel I 'needed a nurse'. He just said that I need someone there to be able to get me to hospital if need be. Uh, yeah, Dr. S. that's the point. Of course he'd be willing to hospitalize me with round the clock nursing care, who check me multiple times a day for fever, pain, cramping and check the baby's heart beat...so I don't really see how this is much different. Likely cheaper for the health care system. Go Emily, saving the province money!
I then had an ultrasound which actually was better than I expected. My AFI was at 6.1! This is low, but adequate for lung development. Flow through the umbilical cord is normal. Baby's measurements are all over the place, but I'm not really concerned about that since bloodflow is normal and adequate for growth, and I think there is a lot of measurement error with the AFI being low. Also, Acorn scored an 8/8 on the biophysical profile, including getting a 2 for 'breathing movements'. I know other pPROM moms have been told this is not an indicator of adequate lung development for breathing outside the womb but it does indicate that Acorn at least has enough room to allow chest expansion and has the neuromuscular control to coordinate his or her diaphragm. Good stuff I hope.
Then I had my glucose tolerance test. That drink isn't that bad. I don't know what everyone complains about.
For the finale, I also had my first steroid shot to assist with lung development. Worth it, but still, Ouch! My whole left gluteus maximus is now sore. Tomorrow I have to go back to get jabbed in the right buttock. Fun times.
I still don't know what we'd do about a C-section at this point. Currently the baby is breech and Dr. S. said that if we really wanted to 'go after this baby' a C-section would be the way to deliver...but he's not sure he would recommend it due to 'poor prognosis' at this point. I must agree. My gut says its not worth it...yet. But a few weeks down the line, if we get there, things might be different.
I really hope we get there. Please Acorn, keep hanging on! Mommy's doing her best to keep you safe.
Update to answer Melissa's question (comment #2): No there is no reason per say that I couldn't go many more weeks...but as Eeyore was saying, it was unlikely 8 weeks ago that I'd still be pregnant today, so any more time is 'pleasantly unexpected' medically. But if you check the pPROM boards on babycenter there are women out there who make it into the 30 week range who ruptured around the same time as I did, so it is technically possible. My cervix is maintaining (3.1 cm measured today), so infection and bleeding are our two major issues, other than having low fluid. Probably the same thing that caused your pPROM at 31 weeks was the same thing that threw you into premature labour (infection or incompetent cervix), but since it was likely my abnormal placenta that caused my pPROM, there is nothing that has (so far) caused labour to start. Things I'm doing to prevent labour is laying around to avoid pressure on the cervix, drinking massive amounts of fluids (4-5 L per day) to prevent dehydration and encourage amniotic fluid build-up. I wash my hands obsessively (before and after going to the bathroom), I take probiotics, extra Vitamin C, D, stool softeners, antibacterial wet wipes after bowel movements and a collagen drink once a day (strengthens tissues, including hopefully my amniotic sac). Hopefully something is helping...but I did almost none of this except the water and the laying around last time and I still lasted 10 weeks post rupture so who knows if this is just how my pPROMs go.