What is Premature Rupture of Membranes (PROM)?

 What is Premature Rupture of Membranes (PROM)?

Introduction

Premature Rupture of Membranes (PROM) is a pregnancy complication in which the amniotic sac the fluid-filled membrane surrounding the baby  breaks before the onset of labor. The amniotic sac, often referred to as the “bag of waters,” provides a protective cushion and sterile environment for the growing baby. When it ruptures too early, it can increase risks for both the mother and baby.

Types of Rupture of Membranes

1. Term PROM
   Occurs at 37 weeks of pregnancy or later, but before labor begins.

2. Preterm Premature Rupture of Membranes (PPROM)
   Occurs before 37 weeks of pregnancy. This is more serious because it can lead to premature birth and complications for the baby.

Causes and Risk Factors

PROM can happen without a clear reason, but several factors increase the risk:

• Infections of the reproductive tract

• Previous history of PROM or preterm birth

• Smoking during pregnancy

• Multiple pregnancies (twins, triplets, etc.)

• Procedures like amniocentesis

• Cervical insufficiency or anatomical issues with the uterus

• Vaginal bleeding during pregnancy

Signs and Symptoms

The most common sign is a sudden gush or slow leak of clear fluid from the vagina.
Other signs may include:

• Constant wetness in underwear

• Fluid with a sweet or bleach-like odor

• Occasionally, mild cramps or backache

Important: Sometimes women mistake urine leakage for amniotic fluid. If unsure, medical evaluation is essential.

How is PROM Diagnosed?

Healthcare providers use several methods to confirm PROM:

• Physical examination with a sterile speculum to check for pooling of fluid

• Nitrazine paper test to check fluid pH

• Ferning test under a microscope (crystallized pattern in amniotic fluid)

• Ultrasound to assess amniotic fluid levels

Potential Complications

If PROM occurs, the protective barrier around the baby is lost, increasing the risk of:

• Infection (chorioamnionitis in the mother, sepsis in the newborn)

• Preterm birth and related complications

• Umbilical cord compression or prolapse

• Placental abruption (separation of placenta from uterus)

Management and Treatment

The approach depends on gestational age, signs of infection, and baby’s condition:

• Term PROM (≥37 weeks): Labor is usually induced to reduce infection risk.

• Preterm PROM (<37 weeks):

• Hospitalization for monitoring

• Antibiotics to prevent infection

• Corticosteroids to speed up fetal lung maturity

• Delivery if signs of infection, distress, or other complications occur

Prevention Tips

While PROM cannot always be prevented, these steps may help lower risk:

• Attend regular prenatal visits

• Avoid smoking and exposure to harmful substances

• Treat genital or urinary infections promptly

• Practice safe sex during pregnancy to reduce infection risk

When to Seek Medical Help

Call your healthcare provider immediately if you:

• Notice a gush or leak of fluid

• Have contractions before 37 weeks

• Develop fever, foul-smelling discharge, or abdominal pain

Bottom Line:
Premature Rupture of Membranes is a serious pregnancy complication that requires prompt medical attention. Early detection, appropriate treatment, and close monitoring can significantly improve outcomes for both mother and baby.

Dr.Ifrah Hassan Hilaac

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