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Pregnancy and Childbirth: Premature Rupture of the Membranes

During pregnancy, the baby is surrounded in the uterus by the amniotic sac. The sac is also called the “bag of waters.” It protects and cushions the baby. Premature rupture of the membranes is when the amniotic sac breaks before you go into labor. Normally, the sac breaks after labor begins and contractions have started. If the rupture occurs at 37 weeks or earlier in pregnancy, it is called preterm premature rupture of the membranes.

Cross section of pregnant woman's pelvis showing baby developing in amniotic sac in uterus. Placenta is attached to inside of uterus. Placenta is attached to baby by umbilical cord. Closeup detail shows tear in amniotic sac.

Are You At Risk for Premature Rupture of the Membranes?

Doctors aren’t sure what causes premature rupture of the membranes. Many times the cause is unknown. Certain risk factors seem to make it more likely. Risk factors include:

  • Lack of prenatal care

  • Smoking during pregnancy

  • Low body weight

  • Bleeding from the vagina during the 2nd or 3rd trimester

  • Having had a sexually transmitted infection

  • Being pregnant with more than one baby

  • Having a history of premature rupture of the membranes in an earlier pregnancy

  • Having had certain medical procedures such as amniocentesis (a test that takes fluid from the amniotic sac) or cerclage (a stitch used to close a weakened cervix during pregnancy)

The Dangers of Premature Rupture of the Membranes

The condition can result in the following serious problems:

  • Bacteria can travel from the vagina into the uterus and cause a dangerous infection.

  • Having low fluid in the womb may cause the umbilical cord to occasionally be squeezed, reducing blood flow to the baby.

  • The placenta can separate from the wall of the uterus (placental abruption). This can lead to severe bleeding.

  • The baby can be born too early. This can cause many problems, including breathing and nervous system problems.

Symptoms of Premature Rupture of the Membranes

The main symptom is fluid leaking or gushing from the vagina. Even though there is loss of fluid, it keeps leaking because the baby is making more. The fluid can be clear or light yellow. Other symptoms include bleeding from the vagina, pain in the lower abdomen or in the low back.

If you have any of these symptoms, call your health care provider right away.

Evaluating Premature Rupture of the Membranes

Your health care provider will ask about your symptoms. Mention if you have recently had contractions, bleeding from the vagina, sexual intercourse, or a fever. He or she will then likely do the following:

  • Examine your vagina and cervix.

  • Take a swab of fluid from the vagina to be examined for the presence of amniotic fluid.

  • Do an ultrasound test to measure amniotic fluid in the uterus.

  • Check your baby’s heart rate and other vital signs.

Treating Premature Rupture of the Membranes

Premature rupture of the membranes is treated based on where you are in your pregnancy:

  • If you are 34 weeks or earlier, you’ll likely be admitted to the hospital. There, you’ll be given antibiotics to prevent infection. You may also be given medication (steroids) to help the baby’s lungs mature. You and the baby will then be carefully monitored for signs of infection. The baby’s lungs may also be tested for how they’re developing. If the baby’s lungs are mature, labor will likely be induced.

  • If you are between 34 and 37 weeks, labor will likely be induced.

  • If you are at 37 weeks or later, your health care provider will likely allow you to go into labor on your own.

Follow-Up

Work with your health care provider. Go to regular prenatal visits and discuss any symptoms you may be having. Together, you can take steps to avoid complications of premature rupture of the membranes. This will ensure your health and the health of your baby.

Author: StayWell Custom Communications
Last Annual Review Date: 9/19/2014
Copyright © The StayWell Company, LLC. except where otherwise noted.
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