Premature rupture of membranes or premature rupture of membranes (PROM) is a condition in which the amniotic sac ruptures before labor begins. This condition can occur either before the fetus matures in the womb (before the 37th week of gestation), or after the fetus matures.
The earlier the rupture of membranes occurs during pregnancy, the more serious the condition. This danger sign of pregnancy needs to be addressed as soon as possible to avoid complications for the mother and the baby.
The characteristics of premature rupture of membranes
Pregnant women will feel the amniotic fluid that comes out of the vagina when the membranes break. This water that comes out can flow slowly or come out fast. Unlike urine, the leakage of amniotic fluid cannot be stopped so it will continue to flow even though you have tried to hold it in.
To better determine whether the fluid is urine or amniotic fluid, you can use a pad to absorb the fluid that comes out. Next look and smell the pads. Amniotic fluid is colorless and does not smell like urine, but tends to have a sweet smell.
In addition to leaking amniotic fluid, premature rupture of membranes can be accompanied by the following symptoms:
- The pelvis feels depressed.
- Vaginal discharge or feeling wetter than usual.
- Vaginal bleeding.
Call your doctor immediately, if you feel your waters breaking.
Causes of premature rupture of membranes
Actually rupture of membranes is a natural thing that occurs when pregnant women are about to give birth. But rupture of the membranes that is not followed by signs of giving birth, especially if it occurs before the fetus matures, is not normal. This condition is known as premature rupture of membranes.
The cause of premature rupture of membranes is not known. However, there are several conditions that are at risk of causing premature rupture of membranes, namely:
- Infection of the uterus, cervix, or vagina.
- The amniotic sac is stretched excessively, due to too much amniotic fluid (polyhydramnios). In certain cases, premature rupture of membranes can also occur in pregnant women who experience a lack of amniotic fluid (oligohydramnios).
- Have vaginal bleeding in the second and third trimesters of pregnancy.
- Pregnant women who are underweight or are malnourished.
- Is pregnant with twins.
- The interval between pregnancies is less than six months.
- Smoking or using drugs while pregnant.
- Have had surgery or a biopsy on the cervix.
- Have given birth to a premature baby.
- Have experienced premature rupture of membranes in a previous pregnancy.
Diagnosis of premature rupture of membranes
Doctors can diagnose premature rupture of membranes from the complaints felt by the patient and through a physical examination. During a physical examination, the doctor will primarily examine the inside of the cervix to ensure that the membranes have ruptured. If necessary, the doctor will also perform additional examinations in the form of:
- pH test, to check the level of acidity of vaginal fluids. If the membranes have ruptured, the level of acidity of the vaginal fluid will be higher (it should be more alkaline).
- ultrasound, imaging with pregnancy ultrasound can be done to check the condition of the fetus and uterus, and see the amount of amniotic fluid that is still remaining.
Treatment of premature rupture of membranes
After the membranes rupture, the doctor will check to see if your baby is ready to be delivered, because delaying delivery after the membranes rupture can lead to infection. If there are no signs of giving birth, the obstetrician will recommend induction to speed up labor.
However, if the premature rupture of membranes occurs before the gestational age reaches 34 weeks, the fetal lungs are not fully formed so that they are not ready to be born. In this condition, the doctor will give corticosteroid drugs to accelerate the maturation of the fetal lungs, so that they can be delivered as soon as possible. To prevent infection, the doctor will also give antibiotics. After the fetus is deemed ready to be born, the doctor will then perform the induction procedure.
Complications of premature rupture of membranes
Premature rupture of membranes can lead to a number of complications. The following are complications that can occur:
- Infection in membrane that covers the fetusor chorioamnionitis
Chorioamnionitis risk of causing serious infections in the mother and fetus, such as pneumonia, meningitis, to sepsis.
- Compressed umbilical cord or umbilical cord compressionLack of amniotic fluid due to premature rupture of membranes can put pressure on the umbilical cord by the fetus. In some cases, the umbilical cord even comes out of the uterus and down into the vagina. Compression of the umbilical cord can cause serious brain injury and even death.
- Babies born premature
Babies born prematurely are at risk for neurological disorders, respiratory problems, and learning difficulties later in life. Although rare, premature rupture of membranes can occur before 24 weeks of gestation and can cause fetal death. Babies born before the 24th week and managed to survive, are at risk for developmental disorders, chronic lung disease, hydrocephalus, and cerebral palsy.cerebral palsy).
Prevention of premature rupture of membranes
There is nothing special that can be done to prevent premature rupture of the membranes. However, because of the association between smoking during pregnancy and premature rupture of membranes, pregnant women are advised not to smoke. Don't forget to check your pregnancy regularly to monitor growth and development of the fetus.