What Is Premature Rupture of
As your baby grows inside your womb, they’re encased in an
amniotic sac. The amniotic fluid cushions your baby, providing protection for
growth. Part of the labor process includes the rupture of membranes (ROM). When
the membranes rupture, it usually means the baby’s birth is going to happen
Sometimes, membranes rupture before labor begins. When this
occurs after 37 weeks gestation, it’s known as premature rupture of membranes (PROM.)
When this occurs before the fetus is 37 weeks, this is known as preterm
premature rupture of membranes (PPROM). Because the membranes prevent
infectious organisms from reaching you and your baby, the risks for infection
are much greater once the membranes have ruptured. The risk continues to
increase the longer that that your membranes have been ruptured prior to
What Are the Symptoms of
fluid levels can vary during your pregnancy. At about 36 weeks, the amount of
fluid is roughly 1 quart. It begins to decrease as your baby grows larger.
your membranes rupture, you may experience a strong gush of fluid. For some women,
the amniotic fluid doesn’t flow as quickly. Instead, you may notice some
unexplained wetness in your underwear that continues with time.
your doctor if you suspect PROM has taken place. They can conduct a physical
exam to determine if PROM has taken place.
What Are the Risk Factors
groups of women are known to be at risk for PROM. Your doctor may discuss these
risks with you. There are many you can’t change, which include:
lower socioeconomic status
significant vaginal bleeding
distention, such as from excess amniotic fluid or pregnancy with multiple
- having a
history of preterm delivery
- having a
history of sexually
transmitted infections, such as chlamydia and gonorrhea
Women experience PROM every day without
any of these risk factors. Some women have multiple risk factors and don’t
experience PROM. If you’re concerned about your unique risks, talk to your
How Is PROM Diagnosed?
doctor will diagnose PROM based on your symptoms and a physical examination.
Your doctor will ask you questions about the fluid leaking, including how much
you noticed leaking and when it began. Your doctor may take a sample of the
fluid. They can test the pH level of the fluid, which can indicate if the fluid
is coming from the membranes. The dried fluid also will create a distinctive,
fern-like pattern when examined under a microscope.
doctor will also likely perform an ultrasound to determine how much fluid is
around your baby. If the fluid has significantly decreased, you’ve likely
How Is PROM Treated?
for PROM depend on how far along your are in your pregnancy. The American Academy
of Family Physicians has a suggested an algorithm for obstetricians to follow
when treating women with PROM.
24 to 31 Weeks Pregnant
you’re 24 to 31 weeks pregnant, your doctor will give corticosteroids to help
your baby’s lungs mature. Antibiotics will also be given to prevent infection.
If possible, your doctor will delay delivery until 34 weeks’ gestation. If your
baby’s lungs seem mature enough, your doctor will deliver your baby earlier.
32 to 33 Weeks Pregnant
you’re 32 to 33 weeks pregnant, your doctor will give you antibiotics and
corticosteroids. They may also perform an amniocentesis or
other tests to determine your baby’s lung maturity to determine when to deliver
your baby. If possible, waiting until 34 weeks’ gestation is preferred.
34 to 36 Weeks Pregnant
34 to 36 weeks pregnant, your doctor will likely recommend delivering your
baby. You’ll also be given antibiotics to reduce your risk of infections from
bacteria such as group B Streptococcus.
you’re 37 weeks along or further, your doctor will likely recommend delivering
What Is the Outlook for
Babies and Moms After PROM?
the risk of infection for both women and their babies. Also, if you experience
PPROM before 24 weeks, your baby is at risk for medical conditions, such as
limb deformities, neurologic impairment, and pulmonary hypoplasia, in which the
lungs don’t develop properly.
doctor will work with you to do everything possible to allow your baby to
mature before delivery to prevent these complications. With prompt care, you
can safely welcome your baby into the world, even if it’s a little earlier than
How Can I Prevent PROM?
care and quitting smoking if you smoke are two ways
you may be able to prevent PROM. There are few other known interventions that
could help prevent PROM from occurring.
help from your doctor immediately if you think your membranes have ruptured.