Shailja Dayal; Peter L. Hong.
Prelabour rupture of membranes (PROM) is defined as rupture of membranes before the onset of labour. When membrane rupture occurs before labour and before 37 weeks of gestation, it is referred to as preterm PROM (PPROM).
Your baby lies in an amniotic sac of fluid sometimes referred to as 'waters'. If your waters break before labour begins it is called Premature Rupture of Membranes (PROM). If PROM occurs before your baby has reached 37 weeks gestation, the medical term is Preterm Premature Rupture of Membranes (PPROM)
PPROM may lead to spontaneous delivery of your baby within hourshours, or it may be weeks until your baby is born. A large proportion of women will go into labour within 7 days of their membranes rupturing. You may be confined to hospital to monitor your pregnancy and prevent complications, or your doctor may allow you to return home depending on your condition. There may be no known cause for your PPROM, however there are some factors that can increase your risk of the condition, these are:
The symptoms associated with PPROM are:
PPROM is usually diagnosed based on the history you give as well as a speculum examination of the vagina and a swab that can detect the presence of amniotic fluid.
If you are diagnosed with PPROM you may need to prepare yourself for the following:
Although there is no cure for PPROM, there are ways to treat the condition.The treatment will depend on your gestation, pregnancy, general health and the severity of your symptoms.
Treatment may include:
You will likely be reviewed by a specialist neonatal (baby) doctor to discuss the implications of PPROM at your gestation.They will be able to give you more information on outcomes for your baby.
It is not unusual for women to mistake the leaking of amniotic fluid for urine, especially when it leaks slowly. If you notice any symptoms or think your membranes may have ruptured call your primary health care provider immediately. They may ask you some of the following questions:
Once PPROM is confirmed by your doctor the length of time before labour commences can be influenced by many factors. Generally, women with PPROM have a 50% chance of labour starting within 24 to 48 hours and a 70-90% chance of going into labour within seven days. If PPROM occurs between 24- and 28-weeks gestation, the length of time before birth is generally longer than if occurring closer to full term.
Depending on your gestation and current health condition, you may be transferred to a tertiary hospital if your current hospital is unable to deliver a preterm baby. This may evoke feelings of worry, anxiety and fear for you and your baby’s future. Asking questions such as treatments, prognosis and what to expect of a preterm baby at your gestation may help you feel more informed. Ask to visit the Neonatal Intensive Care Unit (NICU) or Special Care Nursery (SCN) to become familiar with the experience and environment.
Ranzcog - The Royal Australian and New Zealand College of Obstetricians and Gynaecologists
COPE – Centre for Perinatal Excellence
Pregnancy Birth and Baby
Through the Unexpected – Perinatal Diagnosis
Panda - Perinatal Mental Health