Premature Rupture of Membranes

Premature rupture of membranes (PROM) is when a pregnant woman past 37 weeks has her membranes break (rupture) before labor begins. This sac of fluid surrounds your developing fetus. It holds the fetus in, keeps infection out, and performs other important functions.

CAUSES

Causes that are known:

  • History of previous PROM.

  • Infection of amniotic fluid, cervix, or vagina.

  • Smoking.

  • Lung disease.

  • An excess amount of amniotic fluid.

  • Removing fluid from the amniotic sac (amniocentesis).

  • Connective tissue disorders like rheumatoid arthritis and lupus.

  • Short cervical length in the second trimester.

  • Not enough fluid in the amniotic sac (olighydramnios).

  • Low socio-economic status.

  • Early uterine contractions.

  • Second and third trimester bleeding.

  • Poor nutrition.

  • Total biopsy (conization) of the cervix.

  • Twins or more.

  • Too low body weight.

  • Having to close the cervix with a suture (cervical cerclage).

SYMPTOMS

Gushing or leaking of fluid from the vagina. Sometimes, a little blood is mixed in with the fluid.

DIAGNOSIS

  • Being able to see the fluid coming out of the cervix.

  • Testing the fluid with a special paper.

  • Looking at the fluid under the microscope for ferning (looks like fern leafs).

TREATMENT

  • Hospitalization is required.

  • Medicine may be given to prevent labor.

  • Antibiotics may be given to prevent infection.

  • Labor may be induced if you have not naturally gone into labor.

  • Treatment may be conservative if the pregnancy is before 32 to 34 weeks and there are no signs of infection.

  • If an Infection is present, delivery is necessary no matter how early the birth may be. Going to the hospital, bed rest, and antibiotics are given in these situations.

  • A cesarean delivery will be required if inducement or natural labor is not achieved within 24 hours after PROM.

  • Steroids may be given to the mother to mature the lungs of the fetus.

There is constant study done to decide the best way to handle PROM. Your caregiver may recommend you be transferred to a hospital with a NICU with expert staff and technical assistants. You and your caregiver will decide on the best way for PROM to be handled.