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Premature rupture of the membranes occurs when the bag of water breaks before labor starts.  The bag of water is like a water balloon that surrounds the baby.  The membranes are like the rubber of the balloon.  

PROM occurs in 1 out of ten pregnancies after 37 weeks.  Preterm premature rupture of the membranes is before 37 weeks (PPROM).  This can lead to premature delivery.  Uncontrolled leaking of fluid from the vagina is the main sign.  The amount may be a lot, soaking clothing and bedding, or a little.  Sometimes additional tests may be required to tell if the membranes are ruptured.  A speculum exam of the vaginal canal to look for a pool of typical fluid is often recommended.

Loss of urine with coughing or sneezing, vaginal infections, and normal vaginal secretions may be confused with PROM.

Women should report any unusual fluid leakage to their providers.

Impact on Pregnancy

About 11% of babies in the USA are born prematurely. A fourth to a third of these are due to PPROM.

Delivery will occur within one week in three out of four cases.

The earlier in pregnancy that PPROM occurs, the longer the time before delivery.   In some cases, delivery may not occur for 3-4 weeks. This is good because it gives the fetus more time to grow and develop.  Unfortunately, the risk of early delivery is still very great. So, the earlier in the pregnancy that PROM occurs the greater the potential for problems.

Factors that increase the risk of preterm PROM :

PPROM may result in:

Special Prenatal/Birth/Neonatal considerations

If the home hospital does not have a nursery that can care for preterm babies, most women are transferred to a hospital with a neonatal intensive care unit.  Steroids are often used to help the fetus’s lungs develop quicker.