Preterm Premature Rupture of Membranes
Preterm premature rupture of membranes (PPROM) is when the amniotic sac breaks before 37 weeks of gestation. The sac contains amniotic fluid and the developing baby. In PPROM, the amniotic fluid inside the sac leaks or gushes out of the vagina. This is also known as your water breaking.
PPROM increases the risks of certain pregnancy complications, including:
Call your doctor right away if you suspect that your water has broken.
The causes of PPROM are not clearly understood. Some of the possible causes are:
The following factors may increase your chance of PPROM:
The main symptom of PPROM 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 and urine. Your doctor can do simple tests to determine this.
PPROM 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.
To diagnose PPROM, 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 PPROM depends on when it occurs in the pregnancy. There are other considerations as well which your doctor will discuss with you.
34 weeks or longer of gestation
The doctor will:
32-33 weeks of gestation
The doctor may:
24-31 weeks of gestation
The doctor will provide treatment with antibiotics and steroids. The doctor may attempt to delay delivery until completion of 33 weeks gestation.
Less than 24 weeks of gestation
The doctor may admit you to the hospital for bed rest and to monitor you and your baby. Twenty-four weeks of gestation is about the youngest a baby can be born. The doctor will discuss the risks and benefits of your treatment options.
Researchers are investigating ways to prevent PPROM. Taking preventive antibiotics during the second and third trimester may reduce your risk. You can also take steps for a healthier pregnancy, like quitting smoking.
American Pregnancy Association
National Institute of Child Health and Development
About Kids Health
The Society of Obstetricians and Gynaecologists of Canada
The American College of Obstetricians and Gynecologists. Premature Rupture of Membranes, Practice Bulletin No. 80. April 2007.
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Premature Rupture of Membranes, Practice Bulletin No. 80, April 2007, The American College of Obstetricians and Gynecologists.
Last reviewed October 2012 by Andrea Chisholm