Preterm premature rupture of membranes (PPROM) is when the amniotic sac breaks before 37 weeks of gestation. The sac contains amniotic fluid and the developing baby. In PPROM, the amniotic fluid inside the sac leaks or gushes out of the vagina. This is also known as your water breaking.
The main symptom of PPROM is fluid leaking from the vagina. You may experience a sudden gush of fluid or a slow, constant trickle. It can be difficult to distinguish between a slow amniotic trickle and urine. Your doctor can do simple tests to determine this.
PPROM also increases the risk of infection. Symptoms include a fever above 100.4ºF (38ºC). If you have any of these symptoms, call your doctor right away.
To diagnose PPROM, the doctor may do the following tests:
Visual exam—the doctor may be able to see a trickle of fluid through the cervix, or a pool of fluid collected behind the cervix
A nitrazine paper test—the doctor puts a small amount of fluid on a piece of paper to see if it is amniotic fluid
Look at the fluid under a microscope to see if it is amniotic fluid
Ultrasound—using sound waves, the doctor examines the baby and amniotic sac to see if there is plenty of fluid and the baby is doing well
The doctor will also check you for fever and other signs of infection. He will monitor your baby for any signs of distress.
Treatment of PPROM depends on when it occurs in the pregnancy.
34 weeks or longer of gestation
The doctor will:
Monitor the baby’s heart rate
Induce labor by giving you medicines
Possibly give antibiotics
32-33 weeks of gestation
The doctor may:
Induce labor if your baby’s lungs have matured enough
Possibly give steroids to help your baby's lungs develop faster
Try to delay delivery until completion of 33 weeks gestation
24-31 weeks of gestation
The doctor will provide treatment with antibiotics and steroids. The doctor may attempt to delay delivery until completion of 33 weeks gestation.
Less than 24 weeks of gestation
The doctor may admit you to the hospital for bed rest and to monitor you and your baby. Twenty-four weeks of gestation is about the youngest a baby can be born. The doctor will discuss the risks and benefits of your treatment options.
Researchers are investigating ways to prevent PPROM. Taking preventive antibiotics during the second and third trimester may reduce your risk. You can also take steps for a healthier pregnancy, like quitting smoking.
Please be aware that this information is provided to supplement the care
provided by your physician. It is neither intended nor implied to be a
substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER
IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the
advice of your physician or other qualified health provider prior to
starting any new treatment or with any questions you may have regarding a