PROM - Not Exactly a Fun Night Out

What Is Premature Rupture of Membranes?

Occurring in about 10 percent of all pregnancies, premature rupture of membranes is a situation in which there is a breaking open of the amniotic sac before labor actually begins. Should this happen before 30 weeks gestation, it is called preterm premature rupture of membranes, or PPROM.

A rupture of the membranes may occur naturally at the end of the pregnancy as a result of the natural weakening of the membranes or from the force of contractions. PPROM, before term rupture of the membranes, is frequently caused by an infection in the uterus. There are other factors to consider which may be linked to PROM including situations in which a woman is not able to obtain proper prenatal care, sexually transmitted diseases like Chlamydia or gonorrhea, a previous preterm birth, vaginal bleeding and smoking cigarettes during the pregnancy.

The Problems PROM and PPROM Can Cause

The premature rupture of the membranes is a complicating factor in nearly one third of all premature births with a likelihood that the baby will be born within one week of the rupture. Serious infection of the placental tissues, called chorioamnionitis, is very dangerous to both mother and baby. Other difficulties which may arise include the early detachment of the placenta from the uterus, called placental abruption, the compression of the umbilical cord, the need for a caesarean delivery and infection after delivery.

Symptoms of PROM

While each woman may experience different symptoms of PROM, there are some which are common to the condition such as leaking or gushing of water from the vagina and a constant wetness in the undergarments. If either of these symptoms is present, or if there are any symptoms which are causing uneasiness, consult the physician for a proper diagnosis, as PROM symptoms are similar to other conditions as well.

Diagnosis and Treatment of PROM

The doctor will be able to diagnose PROM in several different ways; by examining the cervix (which may show signs of liquid leaking from the cervical opening), by testing the pH of the fluid and by checking dried fluid under a microscope. An ultrasound may be ordered in which the doctor is able to view internal organs and their functioning as well as assess blood flow through veins and arteries.

Specific treatment will be determined based upon health, the general state of the pregnancy and medical history. Other considerations may be the extent of the condition and expectations in terms of the course of the condition, medication tolerances and allergies and personal preferences and opinions. It may be necessary to be hospitalized or, on the other hand, the leakage from the cervical opening may seal over on its own. Regardless, monitoring is essential to guard against infection. Such things as pain, fever, and changes in the fetal heart rate and lab tests are all essential to the treatment of PROM. Medications to help the baby develop and to be stronger should a premature birth take place are also part of the treatment procedures.