Premature Rupture of Membranes

Amniotic fluid, which is contained in the amniotic sac, surrounds the fetus. In some cases, the membranes of the amniotic sac rupture or break before a woman goes into labor; this is known as premature rupture of membranes (PROM), and also as early water-breaking. During PROM, a woman can feel anywhere from a small trickle to a heavy flow of liquid from the vagina. Most women go into labor within 24 hours of PROM. The longer it takes for labor to begin after the membranes rupture, the greater the risk of infection for the mother and fetus.

Causes of Premature Rupture of Membranes

In many causes, there is no exact cause for PROM. There are, however, risk factors that include the following:

  • Smoking
  • Infection of the cervix, uterus or vagina
  • Multiple pregnancy (which can stretch the amniotic sac)
  • Past cervical surgery or biopsy

Women who experienced PROM with a past pregnancy may be at greater risk for its reoccurrence.

Diagnosis of Premature Rupture of Membranes

PROM is diagnosed after a physical examination of the cervix and uterus. The cervix is checked for dilation, which is a sign that labor is starting. A test may also be administered to determine whether the mother is leaking amniotic fluid.

Treatment of Premature Rupture of Membranes

In most cases, a woman is hospitalized after PROM. If it has occurred before the 37th week of pregnancy, the health of the fetus is evaluated, and an attempt to prolong the pregnancy may be made. The mother may be put on bed rest, either at home or in the hospital, and steroid injections may be given to help the fetus's lungs develop. Antibiotics are prescribed to fight infection. If the pregnancy is past 37 weeks, and labor has not begun on its own, it may be induced.

Complications of Premature Rupture of Membranes

PROM can cause serious complications for the mother and the fetus, especially if it occurs prior to the 34th week of pregnancy. Potential complications include the following:

  • Infection
  • Placental abruption
  • Umbilical-cord problems
  • Premature labor

When PROM occurs before 37 weeks, it is referred to as preterm premature rupture of membranes (PPROM). It occurs in approximately 3 percent of pregnancies.

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