Evan James Jacobson

Diagnosis: Preterm Premature Rupture of Membranes (PPROM)

By Evan's Momma

My fiancé and I had been together for five years when we finally got pregnant with our baby boy, Evan. He was the highlight of our lives and we felt like no other little boy was ever loved as much as Evan was. I'd had another pregnancy in 2000 with a daughter; Emily Rose Farley, where I lost her as well at 35 weeks. So when I got pregnant again we were so happy.

My pregnancy was going just fine until the day I went in to have an ultrasound and got the dreaded news from the doctor. He took us into a room and explained that my cervix was 1/3 the size it was supposed to be and that I needed to have a McDonald cervical cerclage performed. My heart was pounding and I was crying so much, with this terrible news staring us in the face.

After that, we felt like a train had run us over repeatedly. I was scheduled for surgery and I would undergo a spinal block, because that was the safest for my baby and I. After surgery, everything seemed to be going OK. I went back for my next ultrasound and the stitch had broken, from what the doctors believed was contractions. They scheduled another appointment for a second cerclage. This time, I would undergo general anesthesia so that my muscles would relax and they would be able to get the stitch tighter and maybe a little higher.

Before the doctor could do anything at all my water broke, at 18 weeks of pregnancy. What the doctors told us were the worst and most painful words I have ever heard. They said it would mean the baby's lungs would not develop past 18 weeks; the baby would have less than a 1 percent chance of surviving.

I had to make the most difficult decision of my life: should I keep Evan inside me or should I let the doctor's induce labor? All the doctors kept telling me there was a high chance that I would develop a fever and that if it rose to about 100.4 degrees F, I wouldn't have a choice but to have labor induced.

The doctors were very helpful and let us have the time we needed to talk this through. At this point, Evan wasn't developed enough to feel any pain. But we were told that if we decided to wait, there was a chance that he would feel pain.

Those words hit me like a million daggers. That's when I believe I made up my mind. But we still took the time to talk it over. I wasn't going to make this decision alone. This was my fiancee's baby as well, and I needed and wanted his opinion. Ultimately, we both decided that it would be best if to induce labor.

It has been 18 days since I made the hardest decision of my life. I struggle with questions. Did I make the right decision? What if my baby boy was that 1 percent that would have survived? What if he would have been a miracle baby? How can I live with myself for the rest of my life knowing that?

We got all the amnio results back and found out that Evan had no abnormalities. It was like another dagger hitting me. Knowing he was normal and the only thing wrong was my incompetent cervix really made me struggle with my decision. I still struggle with it, and I probably will for the rest of my life.

Note: Preterm premature rupture of membranes (PPROM)can be dangerous to the mother and the fetus. The amniotic sac acts as a protective barrier for the fetus, shielding it from bacteria and viruses. Once the membranes have ruptured, the risk of infection increases the longer the fetus remains in the uterus. Source: http://www.pregnancy-info.net/prom.html.


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