Premature Rupture of Fetal Membranes - PROM

    Premature rupture of fetal membranes (PROM) is when the fetal membranes break prior to labor. The approach to PROM depends on how many weeks along during the pregnancy it happens and if there are other pregnancy complications such as an infection. 

    The amniotic sac is the safety net for baby. As long as baby is inside of the amniotic sac there is little chance of infection from outside bacteria or viruses. When the time comes for labor, the “water” surrounding baby will often break leaving baby ready to move down the birth canal and eventually into the outside world.

    In some cases, the bag of waters will break before labor begins, this is called premature rupture of the fetal membranes (PROM). PROM can happen after 37 weeks (term PROM) or before 37 weeks (preterm PROM). If the amniotic sac is not intact, and as time goes by, there is an increased risk that there will be an infection that can harm both mom and baby.

    Reasons for PROM are often not that clear though there is an association of PROM with existing infections.

    No matter the reason for the early rupture, doctors will follow the same guidelines for treatment. These guidelines depend on when during pregnancy PROM happens or if there are other complications.

    PROM after 37 weeks is called "term PROM," and PROM before 37 weeks is called "preterm PROM" (PPROM).

    If PROM occurs after 34-37 weeks of the pregnancy then risks of infections are considered higher than risks to the baby of prematurity and most doctors will recommend to deliver the baby.

    If PROM happens before 32-34 weeks, and there is no suspicion of an infection or another complication then many doctors will want to wait until the baby has grown more and matured more. Usually antibiotics are give as well as medications to make the baby's lungs and other organs more mature.

    As soon as the membranes rupture, mom will need to contact the obstetrician in charge of her care. The doctor will often admit mom to the hospital

    In many cases, PROM will be followed by labor within the first 24 hours. In cases where spontaneous labor does not occur, and the pregnancy is after 34 weeks the mother will often be prescribed a medication to induce labor. With IV and oral antibiotics, the infection of mother and baby can be stopped, but baby will need to be moved out of the womb in order to ensure the safety of all involved.

    PROM before 34 weeks without labor requires close observation of infections and fetal well-being.

    Premature rupture of membranes can be the body's way of saying labor will begin shortly. In other cases, this rupture may simply be caused by other forces or a weak spot in the amniotic sac. After the “water” breaks, mom will most often give birth to baby within the next few days, though if it happens earlier in pregnancy it may be prefeable to wait longer until baby is more mature.