Definition
Premature rupture of membranes (PROM) at term is when the amniotic sac breaks before labor begins. The sac holds amniotic fluid and the growing baby. With PROM, the amniotic fluid inside the sac leaks or gushes out of the vagina. This is also known as your water breaking.
| Fetus in the Amniotic Sac |
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Risk Factors
Things that may raise the risk of this problem are:
- Being pregnant for the first time
- PROM in earlier pregnancies
- Premature contractions
- First trimester bleeding
- Chlamydia
- Low body mass index
Symptoms
The main symptom of PROM is fluid leaking from the birth canal. There may be a sudden gush or a slow trickle.
PROM raises the risk of infection. There may also be:
- Fever
- Rapid heartbeat
Complications from PROM may be:
- Fetal infection
- Uterine infection
- Placenta separates from the uterus before the baby is delivered— placental abruption
- Umbilical cord is squeezed between the baby and the pelvis— prolapsed umbilical cord
Diagnosis
If a large amount of fluid is leaking from the birth canal, PROM is likely.
It can be hard to tell a slow amniotic trickle apart from urine. These tests may be done:
- Nitrazine paper test—the doctor puts a small amount of fluid on a piece of paper to see if the fluid that is leaking is amniotic fluid
- Microscopic exam of the fluid
Treatment
Labor usually begins within hours after PROM. If labor does not begin, medicine may be given to start it.
The mother and baby will be watched closely to look for signs of any problems.
RESOURCES
American Pregnancy Association http://www.americanpregnancy.org
National Institute of Child Health and Development https://www.nichd.nih.gov
CANADIAN RESOURCES
The Canadian Women's Health Network http://www.cwhn.ca
The Society of Obstetricians and Gynaecologists of Canada http://sogc.org
References
Placental abruption. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/placental-abruption. Accessed March 8, 2022.
Prelabor rupture of membranes. The American College of Obstetricians and Gynecologists website. Available at: https://www.acog.org/clinical/clinical-guidance/practice-bulletin/articles/2020/03/prelabor-rupture-of-membranes. Accessed March 8, 2022.
Premature rupture of membranes at term (term PROM). EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/premature-rupture-of-membranes-at-term-term-prom. Accessed March 8, 2022.