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PREMATURE RUPTURE OF MEMBRANES

(RUPTURE OF AMNIOTIC SAC UNDER 24 HOURS BEFORE ONSET OF LABOR)

CARE AGREEMENT:

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Premature Rupture of Membranes

WHAT YOU NEED TO KNOW:

What is premature rupture of membranes? Premature rupture of membranes (PROM) is a condition where fluid leaks from your amniotic sac before labor begins. The amniotic sac contains fluid that surrounds and protects your unborn baby in your uterus. PROM may happen just before birth. If PROM happens before 37 weeks of pregnancy, it is called preterm PROM. You may feel a gush of warm fluid or a slow trickle of fluid from your vagina.

What increases my risk for PROM?

  • Premature delivery or PROM in a previous pregnancy

  • Infection, such as a STD, pneumonia, or UTI

  • Enlarged uterus caused by more than 1 baby or extra amniotic fluid

  • Surgery on your cervix or an amniocentesis

  • Abnormally shaped uterus or a short cervix

  • Vaginal bleeding during the second or third trimester

  • Poor nutrition, alcohol, or smoking

How is PROM diagnosed? Your healthcare provider will ask you about your medical history and your current symptoms. You may need any of the following:

  • A vaginal exam may show if you are leaking amniotic fluid or if your cervix is dilated.

  • A sample of vaginal fluid may show if you are leaking amniotic fluid or if you have an infection.

  • Blood and urine tests may show infection or provide information about your and your baby's condition.

  • An ultrasound uses sound waves to show pictures on a monitor. An ultrasound may show the position of your baby and his weight. Healthcare providers may monitor your baby's heartbeat and the contractions of your uterus. An ultrasound may also show the location of the placenta and how much amniotic fluid is in your uterus.

  • An amniocentesis may show if your baby's lungs are developed enough for delivery. This test is also used to check for infection in your uterus.

How is PROM treated? The goal of treatment is to delay delivery of your baby if possible. You will be admitted to the hospital. You may need any of the following:

  • Bed rest may be needed if you are not ready to deliver. Your healthcare provider may recommend bed rest for several weeks of your pregnancy.

  • Medicines:
    • Antibiotics help treat or prevent an infection caused by bacteria.

    • Oxytocin is used to start contractions and keep them strong and regular. It may be used at any time after your membranes have ruptured.

    • Tocolytics are given to stop contractions for a short time if your baby is not ready to be born.

    • Steroids are given between 24 and 34 weeks gestation to help your unborn baby's lungs develop faster.

  • Delivery:
    • Vaginal delivery may be needed. You may begin to have contractions shortly after your membranes have broken, or contractions may start later. Healthcare providers may wait to see how you and your baby are doing and allow labor to continue naturally. They may give you medicine to slow down contractions, or they may need to induce (start) labor.

    • A C-section may be needed if your labor is not progressing or if your baby has problems, such as a low heart rate.