Premature rupture of membrane (PROM) refers to breaking open (or rupturing) of the membranes of the amniotic sac prior to the onset of labor. Premature membrane rupture is observed in approximately 10% of all deliveries. Membrane rupture prior to completion of 37 weeks of pregnancy is referred to as preterm rupture of membranes and accounts to one third of all preterm births.
Causes Of Premature Rupture Of Membranes
The amniotic sac provides protection and nourishment to the growing fetus throughout pregnancy. As pregnancy nears its end, the membrane of the amniotic sac ruptures and triggers uterine contractions, which in turn helps in normal delivery.
However, in some cases, the membranes tend to rupture before time, which is a cause of concern, since the fetus is not completely matured or ready. There are a host of causative factors that are attributed to premature rupture of membranes,
- Infection is the most common cause of premature membrane rupture. The infection could be attributed to sexually transmitted diseases like gonorrhea, chlamydia or may be attributed to other infections (e.g. E coli) due to poor uterine hygiene. For this reason, premature rupture of membrane is more frequently observed in women belonging to the lower socioeconomic strata.
- History of preterm birth is also commonly linked with premature rupture.
- History of bleeding during pregnancy due to placenta previa or abrupto placenta is one of the common causative factors.
- Cigarette smoking during pregnancy can also act as a contributing factor.
Premature Rupture Of Membranes Symptoms
While premature rupture of membranes is characterized by gush of fluid or constant wetness of the underwear, the condition can be associated with serious health implications for the mother and the unborn child.
The risks associated with premature rupture of the membrane include premature birth (i.e. in most cases delivery occurs within a week of the membrane rupture). Other risk factors include,
- Infection of the placental tissues (choriomanionitis).
- Risk of early detachment of the placenta.
- Compression of the umbilical cord.
- Risk of postpartum infection.
- Cesarean birth ( i.e. risk of not a normal birth).
Treatment Guidelines For Premature Rupture Of Membranes
The treatment of premature rupture of membranes often depends upon how quickly the condition has been diagnosed. A physical examination of the cervix or testing the pH of the fluid can help in making the diagnosis. An ultrasound examination can help access the level of fluid loss and the overall health of the fetus.
The treatment often depends upon the extent of fluid loss, the duration of the pregnancy and an individual’s overall health status.
- The patient is observed for a few days, since in some cases the membranes seal over and the leaking may stop without any treatment. However it is important to observe the patient and hence hospitalization is inevitable. During hospitalizations, the patient’s vital signs are monitored i.e. heart rate, breathing rate, etc. along with monitoring potential symptoms of infection e.g. fever, pain, etc.
- Antibiotics are considered critical to avert infection and also reduce the health risk for the mother and the fetus.
- Warm milk with two teaspoons of turmeric and raw honey helps avert infection and enhances overall health of the fetus and the mother. While alternative therapies are not recommended to treat the condition, they can be used in conjunction with contemporary medicine protocols.