PROM

complications

complications

function of Amniotic Sac

function of Amniotic Sac

Premature Rupture Of Membranes

Premature Rupture Of Membranes

chorioamnionitis

chorioamnionitis

Things to remember when your water broke

Things to remember when your water broke

Etiology & Risk Factors

Etiology & Risk Factors

PMS & It's Effects

PMS & It's Effects

Preterm Prelabour Rupture of Membranes

Preterm Prelabour Rupture of Membranes

  • Your baby is surrounded by amniotic fluid or ‘waters’ contained within a membrane bag (the amniotic sac) inside your uterus.
  • When the waters break, it is also known as rupture of the membranes. Normally your waters break shortly before or during labour. If your waters break before labour at less than 37 weeks of pregnancy, this is known as preterm prelabour rupture of membranes (PPROM). This can happen in up to 3 out of every 100 (3%) pregnant women. PPROM is associated with 3 to 4 in 100 preterm births.
  • The reason why PPROM happens is not always known but may be because of infections, placental problems or other causes.

  • You may notice a ‘gush’ of fluid through vagina consistency is like urine & quantity is more then your routine vaginal discharge of pregnancy.

  • PROM / PPROM is best diagnosed by a vaginal examination. your doctor will use a sterile speculum (an instrument used to separate the walls of the vagina) to look at your cervix and see whether the leaking fluid is amniotic fluid.

  • An ultrasound scan to estimate the amount of fluid around your baby is sometimes helpful.

  • If your waters have broken, you will usually be advised to stay in hospital for a few days, although in some situations this may be for longer. You and your baby will be closely monitored for signs of infection. This will include having your temperature, blood pressure and pulse taken regularly, together with blood tests to check for infection. Your baby’s heart rate will also be monitored regularly.
  • If your waters have not broken, you should be able to go home.
  • If only a very small amount of amniotic fluid is leaking, it is not always easy to see on examination and it can be difficult to confirm whether your waters have broken. If you continue to leak fluid at home, you should return to the hospital for a further check-up.

Infection

  • The membranes form a protective barrier around the baby, and after these have broken, there is a risk of infection getting into your uterus (chorioamnionitis). If you have an infection, this can cause you to go into labour early or cause you or your baby to develop sepsis.
  • The symptoms of infection include a raised temperature, an unusual vaginal discharge with an unpleasant smell, a fast pulse rate and pain in your lower abdomen. Your baby’s heart rate may also be faster than normal.
  • If there are signs that you have an infection, your baby may need to be born straight away to try to prevent both you and your baby becoming more unwell.

Preterm birth

  • About 50% of women with PPROM will go into labour within the first week after their waters break. The further along you are in your pregnancy the more likely you are to go into labour within 1 week of your waters breaking.

Problems of prematurity

  • Babies born prematurely have an increased risk of health problems, particularly with breathing, feeding and infection, and may need admission to a neonatal unit. The earlier your baby is born, the more likely that this will be the case.
  • If your waters have broken early, your doctor will discuss with you the possible outcomes for your baby, depending on how many weeks pregnant you are when this happens and on your individual circumstances.

Other complications

  • Cord prolapse, when the umbilical cord falls through your cervix into the vagina: this is an emergency complication and can be life-threatening for your baby, but it is uncommon.
  • Placental abruption, when your placenta separates prematurely from your uterus: this can cause heavy bleeding and can be dangerous for both you and your baby.
  • If you experience PPROM, sometimes your baby may not survive. The risk of this happening is greater if your waters break very early, * if the baby is born very prematurely or, in some cases, following infection or cord prolapse.

  • There is no medicine or remedy available which can seal your hole.
  • It is not possible to replace the fluid or repair the hole in the membranes around your baby. You may carry on leaking fluid for the rest of your pregnancy as amniotic fluid continues to be made.
  • However, treatment may be offered to reduce the risk to your baby. This could include:
    • A course of antibiotic tablets to reduce the risk of an infection getting into the uterus and affecting both you and your baby; antibiotics can also help to delay you going into labour
    • Course of steroid injections (corticosteroids) to help with your baby’s development and to reduce the chance of problems caused by being born preterm.
    • Magnesium sulfate, a medication that may be offered to you if your baby is at risk of being born very prematurely; this can reduce the risk of them developing cerebral palsy
    • Intravenous antibiotics (if you are in preterm labour) to reduce the risk of early-onset group B Streptococcus (GBS) infection.

  • You will usually be advised to stay in hospital for a few days after your waters break, to monitor both your and your baby’s wellbeing. Your doctor will discuss with you the option of going home after this time, if you are well and not considered to be at higher risk for giving birth early.

  • Before going home from hospital, your doctor will give you information on symptoms to look out for. Contact your healthcare professional and return to the hospital immediately if you experience any of the following:
    • Raised temperature
    • Flu-like symptoms (feeling hot and shivery)
    • Vaginal bleeding
    • If the leaking fluid becomes greenish or smelly
    • Contractions or cramping pain
    • Abdominal pain or back pain
    • If you are worried that the baby is not moving as normal.

  • You should have regular check-ups with your doctor (usually one or two times per week). During these check-ups, your baby’s heart rate will be monitored, your temperature, pulse and blood pressure will be checked and you will have blood tests looking for signs of infection. Your obstetrician will work with you to make an ongoing plan for your pregnancy.

  • If you and your baby are both well with no signs of infection or other problem then you may be advised to wait until 37 weeks to give birth. This is because carrying on with the pregnancy reduces the risk to your baby that are related to being born preterm.

  • Your doctor should discuss the timing of birth with you depending on your individual circumstances and preferences.

  • It is often possible to have a vaginal birth after PPROM but this will depend on when you go into labour, the position your baby is lying in in your uterus, and your own individual circumstances and choices.

  • Having PPROM or giving birth prematurely means that you are at an increased risk of having a preterm birth in any future pregnancies.

  • PPROM – Preterm Premature Rupture Of Membranes before 37 weeks of pregnancy.
  • PROM - Premature Rupture Of Mambranes ( Water break prematurely ) at or beyond 37 weeks of pregnancy. Occurs in approximately 10% of pregnancies.
  • Preterm premature rupture of membranes (PPROM) is when your waters break before 37 completed weeks of pregnancy but you haven’t gone into labour yet.
  • If this happens, you have a higher chance of giving birth prematurely and there is an increased chance that both you and your baby may develop an infection that can make you both unwell.
  • You will be offered a course of antibiotics to reduce the risk of an infection developing and to help the pregnancy to continue.
  • If you are well with no signs of infection and your baby is growing well in your uterus (womb), then it may be better to allow your pregnancy to continue until 37 weeks. You will be monitored very closely for any signs of infection by your healthcare team, and your individual circumstances and preferences will be taken into account.
  • If you or your baby show any signs of infection or develop other complications, you may need to give birth to your baby straight away.