Premature rupture of membranes

The tearing of the sac of amniotic fluid that surrounds the baby is refered to as the rupture of the membranes or the "waters breaking". If it happens before labor begins, the adjective "preterm" or PROM is added.  

Most PROMs happen in full-term babies when they are 37 weeks or more along in their pregnancy. When it happens earlier, it is called preterm premature rupture of membranes, or PPROM.  

Symptoms include the appearance of fluid in the vagina, often making the mother feel as if she has urinated. Ideally, the fluid is clear, although it may be stained with feces and/or blood. In more than 70% of cases, it is followed by uterine contractions that begin spontaneously within the first 24 hours. 

Diagnosis is made by clinical questioning and vaginal examination; a speculum may be used to visualize the cervix and rupture of the membranes. 

If PROM occurs, the physician and/or midwife should be contacted as soon as possible. Treatment depends on the weeks of gestation. For full-term babies, labor will be induced if it does not begin spontaneously. In pregnancies less than 34 weeks, rest, antibiotics, corticosteroids to promote lung maturation, and hospital monitoring are usually indicated. In pregnancies under 32 weeks, magnesium sulfate is also usually given to promote brain development and prevent brain bleeding.