Premature rupture of membranes

It is known as "membrane rupture" or "water breaking", when the sac containing the amniotic fluid that surrounds the baby, breaks. When this happens before the delivery work starts, the adjective "preterm or premature" or PMR/PROM is added to it.

The majority of PMRs happen in term pregnancies after having reached the 37th week of pregnancy or more. If this happens before that, it is known as Preterm Premature Membrane Rupture or PPROM.

It is manifested through the appearance of a vaginal discharge that makes the gestant think that they have wet themselves. Ideally, the discharge will be transparent but it can also be tinted by faeces and/or blood. In 70% of the cases or more, it is followed by uterine contractions that will initiate spontaneously during the first 24 hours.

Diagnosis is reached through an interrogation and vaginal exploration; using a speculum to directly see the uterine neck and membranes rupture.

Once the PMR is produced, the doctor and/or midwife must be contacted as soon as possible. How to manage it will depend on the gestational weeks. In term pregnancies the delivery will be artificially induced if not initiated spontanously. In pregnancies of less than 34 weeks it is usually indicated to be at rest, antibiotics and coticosteroids to ensure lung maturity and inpatient observation. In pregnancies of less than 32 weeks, in addition to that, magnesium sulfate is administered to ensure brain development and cerebral haemorrhage prevention.