Premature Rupture Of Membranes

WHAT YOU SHOULD KNOW:

Premature rupture of membranes (PROM) is a condition where fluid leaks from your amniotic sac before labor begins. The amniotic sac contains fluid that surrounds and protects your baby in your uterus. PROM may happen just before birth. If PROM happens before 37 weeks of pregnancy, it is called preterm PROM. The cause of PROM is not known.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

RISKS:

  • You may get an infection that may spread to your baby or to other parts of your body. The placenta may separate from the walls of your uterus and cause bleeding. This blood loss may be life-threatening for you and your unborn baby. You may get a blood clot in your leg or arm. The clot may travel to your heart or brain and cause life-threatening problems, such as a heart attack or stroke. You may need a dilation and curettage (D and C) to remove parts of the placenta from your uterine wall.

  • PROM may cause your unborn baby to press on his umbilical cord and cut off his blood supply. If your baby is born before his lungs are formed, he may have trouble breathing, pneumonia, or other lung problems. PROM may cause your baby to have other life-threatening conditions. Your baby may not be in a head-down position, which can make it harder to deliver him. Caregivers may need to do a Cesarean section to deliver your baby.

WHILE YOU ARE HERE:

Informed consent

is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.

An IV

is a small tube placed in your vein that is used to give you medicine or liquids.

Pressure stockings:

These are long, tight stockings that put pressure on your legs to promote blood flow and prevent clots. You may need to wear pressure stockings before or after surgery or if you have poor circulation (blood flow).

Medicines:

You may need any of the following:

  • Antibiotics: This medicine is given to help treat or prevent an infection caused by bacteria.

  • Oxytocin: This is used to start labor. It causes contractions to start and stay strong and regular. It may be used at any time after your membranes have ruptured.

  • Tocolytics: This is given to stop contractions. You may need this medicine if your baby is not ready to be born and you are having contractions.

  • Steroid medicine: This is given between 23 and 34 weeks to help your unborn baby's lungs develop faster.

Tests:

  • Vaginal fluid swab: A sample of fluid is taken from your vagina to see if it is amniotic fluid. The fluid may show if you are likely to deliver your baby soon.

  • Vaginal exam: This is done to learn if you are leaking amniotic fluid. In a vaginal exam, caregivers may be able to see if your cervix is dilating (starting to open). Caregivers will check your cervix if they think you are in labor.

  • Cultures: These may be done to check for urine or vaginal infections. Cultures can show what germs are causing the infection so caregivers know what type of medicine to give you.

  • Fetal monitoring: Caregivers may monitor your baby's heartbeat and the contractions of your uterus. Monitoring allows your caregiver to check your baby's heart rate. He can also tell if there may be a problem, such as your baby pressing on the umbilical cord. Monitoring also allows your caregiver to see if you are having contractions that you do not feel.

  • Fetal ultrasound: An ultrasound uses sound waves to show pictures of your unborn baby on a monitor. An ultrasound may be done to check how much amniotic fluid is remaining and to check your placenta.

  • Lung maturity test: This is done to check if your baby's lungs are strong enough for him to be born. Caregivers may do this by testing a small amount of the leaking amniotic fluid or by amniocentesis.

  • Nonstress test (NST): This test is a simple way for your caregiver to check how your baby is doing. It uses a fetal heart monitor to watch your baby's heart rate. A baby's heart rate usually increases when he moves around or when your uterus has a contraction. A contraction is when the muscles of your uterus tighten and loosen. You may sit in a reclining chair or with the head of your bed raised during this test. Your caregiver may ask you to stand up or move around during the test. You may need this test more than once.

  • Amniocentesis: Caregivers may do an amniocentesis to check if you have an infection in your uterus.

Treatments:

Treatment depends on your unborn baby's age, his health, and how strong his lungs are. Your treatment may change after tests have been done. It may include any of the following:

  • Monitoring: Caregivers may wait to see if you start to have contractions and if labor begins. They will watch you and your unborn baby carefully during this time. Caregivers may do tests to monitor you and your baby. You may be on bed rest during this time, but you will be able to get up to use the bathroom. If you need to get out of bed, ask your caregiver first.

  • Delivery:

    • Vaginal delivery: You may begin to have contractions shortly after your membranes have broken, or contractions may start later. Caregivers may wait to see how you and your baby are doing and allow labor to continue naturally. They may give you medicine to slow down contractions, or they may need to induce (start) labor.

    • Cesarean section: Caregivers may need to do a Cesarean section (C-section) to deliver your baby. It may be done if your labor is not progressing or if your baby has problems, such as a low heart rate.

© 2014 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

Learn more about Premature Rupture Of Membranes (Inpatient Care)

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