What is premature rupture of membranes?
Premature rupture of membranes (PROM) is a rupture (breaking open) of the membranes (amniotic sac) before labor begins. If PROM occurs before 37 weeks of pregnancy, it is called preterm premature rupture of membranes (PPROM).
PROM occurs in about 8 to 10 percent of all pregnancies. PPROM (before 37 weeks) accounts for one fourth to one third of all preterm births.
What causes premature rupture of membranes?
Rupture of the membranes near the end of pregnancy (term) may be caused by a natural weakening of the membranes or from the force of contractions. Before term, PPROM is often due to an infection in the uterus. Other factors that may be linked to PROM include the following:
Low socioeconomic conditions (as women in lower socioeconomic conditions are less likely to receive proper prenatal care)
Sexually transmitted infections, such as chlamydia and gonorrhea
Previous preterm birth
vagin*l bleeding
Cigarette smoking during pregnancy
Unknown causes
Why is premature rupture of membranes a concern?
PROM is a complicating factor in as many as one third of premature births. A significant risk of PPROM is that the baby is very likely to be born within a few days of the membrane rupture. Another major risk of PROM is development of a serious infection of the placental tissues called chorioamnionitis, which can be very dangerous for mother and baby. Other complications that may occur with PROM include placental abruption (early detachment of the placenta from the uterus), compression of the umbilical cord, cesarean birth, and postpartum (after delivery) infection.
What are the symptoms of PROM?
The following are the most common symptoms of PROM. However, each woman may experience symptoms differently. Symptoms may include:
If you notice any symptoms of PROM, be sure to call yourdoctor as soon as possible. The symptoms of PROM may resemble other medical conditions. Consult your doctor for a diagnosis.
How is premature rupture of membranes diagnosed?
In addition to a complete medical history and physical examination, PROM may be diagnosed in several ways, including the following:
An examination of the cervix (may show fluid leaking from the cervical opening)
Testing of the pH (acid or alkaline) of the fluid
Looking at the dried fluid under a microscope (may show a characteristic fern-like pattern)
Ultrasound. A diagnostic imaging techniquethat uses high-frequency sound waves and a computer to create images of blood vessels, tissues, and organs. Ultrasounds are used to view internal organs as they function, and to assess how much fluid is around the baby.
Treatment for premature rupture of membranes
Specific treatment for PROM will be determined by your doctor based on:
Your pregnancy, overall health, and medical history
Extent of the condition
Your tolerance for specific medications, procedures, or therapies
Expectations for the course of the condition
Your opinion or preference
Treatment for premature rupture of membranes may include:
Hospitalization
Expectant management (invery fewcases of PPROM, the membranes may seal over and the fluid may stop leaking without treatment, although this is uncommon unless PROM was from a procedure, such as amniocentesis, early in gestation)
Monitoring for signs of infection, such as fever, pain, increased fetal heart rate, and/or laboratory tests.
Giving the mother medications called corticosteroids that may help mature the lungs of the fetus (lung immaturity is a major problem of premature babies). However, corticosteroids may mask an infection in the uterus.
Antibiotics (to prevent or treat infections)
Tocolytics. Medications used to stop preterm labor.
Women with PPROM usually deliver at 34 weeks if stable. If there are signs of abruption, chorioamnionitis, or fetal compromise, then early delivery would be necessary.)
Prevention of premature rupture of membranes
Unfortunately, there is no way to actively prevent PROM. However, this condition does have a strong link with cigarette smoking and mothers should stop smoking as soon as possible.
FAQs
Sometimes the membranes break before a woman goes into labor. When the water breaks early, it is called premature rupture of membranes (PROM). Most women will go into labor on their own within 24 hours. If the water breaks before the 37th week of pregnancy, it is called preterm premature rupture of membranes (PPROM).
How serious is premature rupture of membranes? ›
A significant risk of PPROM is that the baby is very likely to be born within a few days of the membrane rupture. Another major risk of PROM is development of a serious infection of the placental tissues called chorioamnionitis, which can be very dangerous for mother and baby.
How long can you stay pregnant with PPROM? ›
The vast majority of women proceed to active labor and deliver soon after PPROM. With appropriate therapy and conservative management, approximately 50% of all remaining pregnancies deliver each subsequent week after PPROM. Thus, very few women remain pregnant more than 3-4 weeks after PPROM.
What is the survival rate for PPROM? ›
A recent study reports a 90% survival rate for infants exposed to prolonged PPROM occurring between 18-24 weeks who were delivered after 24 weeks.
What causes PROM in pregnancy? ›
In most cases, the cause of PROM is unknown. Some causes or risk factors may be: Infections of the uterus, cervix, or vagin*. Too much stretching of the amniotic sac (this may happen if there is too much fluid, or more than one baby putting pressure on the membranes)
Is rupturing membranes the same as breaking water? ›
During pregnancy, your baby is surrounded and cushioned by a fluid-filled membranous sac called the amniotic sac. Typically, at the beginning of or during labor your membranes will rupture — also known as your water breaking. If your water breaks before labor starts, it's called prelabor rupture of membranes (PROM).
Can a baby survive premature rupture of membranes? ›
Can a baby survive premature rupture of membranes? Yes, the fetus can survive if your water breaks too soon. It depends on factors like the age of the pregnancy and how much amniotic fluid is left.
Does PPROM mean miscarriage? ›
Preterm premature rupture of membranes (PPROM) complicates 1 % of all pregnancies and occurs in one third of all preterm deliveries. Midtrimester PPROM is often followed by spontaneous miscarriage and elective termination of ongoing pregnancies is offered in many countries.
How likely is PPROM to happen again? ›
However, the identified risk of recurrent PPROM at <37 weeks gestation (n=4 studies, 3138 women) was 7% (95% CI 6% to 9%) with an I2 of 51% and the risk of recurrent PTL at <37 weeks' gestation (n=3 studies, 2852 women) was 23% (95% CI 13% to 33%) with an I2 of 97.3% (figure 3).
What is the difference between PROM and PPROM? ›
Premature rupture of membranes (PROM) is the rupture of gestational membranes prior to the onset of labor. When membrane rupture occurs before 37 weeks of gestation, it is referred to as preterm PROM (PPROM).
Approximately 50% of women experiencing PPROM (<37 WG) give birth within 24–48 h after the rupture, and 70% to 90% within 7 days [13]. Patients experiencing PPROM require clinical management in a hospital that provides the necessary care for premature newborns [14].
How likely is labour after PPROM? ›
About 50% of women with PPROM will go into labour within the first week after their waters break. The further along you are in your pregnancy the more likely you are to go into labour within 1 week of your waters breaking.
What is the most common complication of PPROM? ›
PPROM raises the risk for infection. It also increases your chance of having your baby too early. Treatment may include medicine to help your baby's lungs develop. Or you may need medicine to stop preterm labor.
What is the most fatal complication of PROM to the fetus? ›
The common complications of PROM are infection in the mother and/or the fetus/newborn, cord prolapse, intrauterine fetal asphyxia/death, placental abruption, preterm labour, and deformity of the fetal limbs.
How long can a fetus survive without amniotic fluid? ›
Can a baby live without amniotic fluid? No. A fetus needs some amniotic fluid in the uterus to survive. However, the exact amount of amniotic fluid it needs depends on its gestational age and other factors.
Can baby kicks break water? ›
Typically, your water will break because your contractions or baby put pressure on it — like popping a balloon from the inside.
How long does it take for an amniotic sac to reseal? ›
In the small rupture model, average complete closure of amnion was 83% at 24 h and 98% at 72 h (Fig. 3B). In the large rupture model, however, closure rates were only 7% at 24 h and 48% at 72 h (Fig.
How long does it take to deliver after PPROM? ›
Research shows that the majority of women with PPROM will give birth within one week of membrane rupture. If you are between 24 to 34 weeks pregnant you will be offered two steroid injections 12 hours apart.
Can a baby survive a PPROM at 16 weeks? ›
A study on 73 pregnant women, complicated with PPROM between 16 and 26 weeks, suggested that gestational age at PPROM is the main contributing factor for perinatal survival. 12 This study revealed that neonatal complications and poor outcomes from PPROM before 23 weeks of gestation are high.
