Premature rupture of membranes (PROM) is the breaking of the amniotic sac before labor begins. The sac contains amniotic fluid and the developing baby. With PROM, the amniotic fluid inside the sac leaks or gushes out of the vagina. This is also known as your water breaking.
PROM occurs during the third trimester after 37 weeks of gestation. A related condition called preterm premature rupture of membranes (PPROM) occurs before 37 weeks of gestation.
PROM increases the risks of certain pregnancy complications, including:
Call your doctor right away if you suspect that your water has broken.
The causes of PROM are not clearly understood. Some of the possible causes are:
The following factors may increase your chance of PROM:
The main symptom of PROM 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 or urine. Your doctor can do simple tests to determine this.
PROM 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.
If a large amount of fluid is leaking from the vagina, diagnosing PROM can be straightforward. To confirm the diagnosis, the doctor may do the following tests:
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 PROM depends on when it occurs in the pregnancy. If it is close to your due date, you and your baby will be watched closely. For example, your baby’s heart rate will be monitored.
Labor usually begins within 24 hours after PROM. If labor does not begin soon after your water breaks, the risk of infection increases. In many cases, labor will be induced by giving you medicines. Antibiotics may also be given.
Researchers are investigating ways to prevent PROM. Taking antibiotics during the second and third trimester may reduce your risk. Taking vitamin C may also lower your chance of developing PROM. You can also take steps for a healthier pregnancy, like quitting smoking .
RESOURCES:
American Pregnancy Association
http://www.americanpregnancy.org/
National Institute of Child Health and Development
http://www.nichd.nih.gov/
CANADIAN RESOURCES:
About Kids Health
http://www.aboutkidshealth.ca/
The Society of Obstetricians and Gynaecologists of Canada
http://www.sogc.org/index_e.asp/
References:
Cunningham FG, et al. Williams Obstetrics. 22nd ed. New York, NY: McGraw-Hill Medical Publishing Division; 2005.
DynaMed editors. Premature rupture of membranes at term (term PROM). EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php. Updated May 2010. Accessed June 1, 2010.
Eisenberg A, Murkoff HE, Hathaway SE. What to Expect When You’re Expecting. New York: Workman Publishing; 2002.
Ferris DG. Management of bacterial vaginosis during pregnancy. Am Fam Physician. 1998;57(6).
Jeffcoat MK, et al. Periodontal disease and premature birth: results of a pilot intervention. J Periodontology. 2003;74(8);1214.
Kohnle D. Placental abruption. EBSCO Health Library website. Available at: http://www.ebscohost.com/thisTopic.php?marketID=15topicID=81. Updated May 2008. Accessed December 1, 2008.
Pregnancy Info.net. Premature rupture of membranes: causes, risks, and treatment. Pregnancy Info.net website. Available at: http://www.pregnancy-info.net/prom.html. Accessed June 1, 2010.
Premature rupture of membranes. CHC Wausau Hospital Medical Library and Patient Education website. Available at: http://www.chclibrary.org/micromed/00061770.html. Accessed August 31, 2005.
Premature Rupture of Membranes, Practice Bulletin No. 80, April 2007, The American College of Obstetricians and Gynecologists.
Last reviewed June 2010 by Ganson Purcell Jr., MD, FACOG, FACPE
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 medical condition.
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