When membranes rupture in the normal course of pregnancy, it’s near the very end, and known as ‘water breaking.’ It is often a sign of the beginning of labor. When membranes rupture before the 37th week of pregnancy and without labor contractions, it’s called preterm prelabor rupture of membranes (PPROM).
PPROM can cause preterm labor because it can result in preterm contractions, increased risk of infection, or bleeding from early placental detachment. It appears in about 8-10% of all pregnancies, and causes about between one-fourth and one-third of preterm births, according to the Children’s Hospital of Philadelphia.
What causes membranes to rupture early?
In terms of mechanics, membranes rupture early when they weaken and thin out, but in many cases, it’s impossible to tell why that happens. However, there are some common risk factors:
- Infections, including STIs like chlamydia and gonorrhea
- Smoking during pregnancy
- A history of PPROM or preterm birth
- If the amniotic sac is stretched out, either by extra amniotic fluid or multiple babies
- A history of cervical procedures or surgeries
- A shortened cervix
- Hypertension and diabetes in pregnancy
If you have any of these risk factors, it’s a good idea to keep open lines of communication with your healthcare provider so they can help you with strategies to lessen your risks.
What happens next?
If membranes rupture after 34 weeks, there’s a good chance that the risk of infection is higher than the risk of the baby having problems from being premature, and your doctor may recommend induction of labor. If membranes rupture earlier than 34 weeks, or if there’s another medical reason why it’s safer for the baby to gestate for as long as possible, you may be prescribed IV and oral antibiotics to prevent infections from occurring (prolonging the pregnancy), and your healthcare provider may recommend admission to the hospital with decreased activity or modified bed rest. The baby may also be treated with corticosteroids to accelerate fetal lung maturation and magnesium sulfate to protect nerve cells that assist with brain development, which can decrease the complications associated with a preterm delivery.
Although PPROM is a serious issue to look out for, it’s important to remember that the majority of women who have had a preterm birth in the past do not go on to have another.
Depending on your risk factors, there might be interventions available to help reduce your risk. Regularly attending your prenatal visits is a great way to make sure your healthcare provider can monitor for conditions such as a short cervix or high blood pressure to stay in the loop when it comes to your health.
Reviewed by the Ovia Health Clinical Team
Sources
- Premature Rupture of Membranes (PROM)/Preterm Premature Rupture of Membranes (PPROM) https://www.chop.edu/conditions-diseases/premature-rupture-membranes-prompreterm-premature-rupture-membranes-pprom
- “Preterm Premature Rupture Of Membranes (PPROM).” MountSinai. Icahn School of Medicine at Mount Sinai, 2016. Web.
- TM Medina, DA Hill. “Preterm Premature Rupture of Membranes: Diagnosis and Management.” Am Fam Physician. 73(4):659-664. Web. Feb 15 2006.
- Premature rupture of the membranes.” MedlinePlus. US National Library of Medicine, May 16 2016. Web.
- “Preterm Premature Rupture of Membranes (PPROM).” URMC. University of Rochester Medical Center, 2016. Web.
- “Preterm (Premature) Labor and Birth: Resource Overview.” ACOG. American College of Obstetricians and Gynecologists, 2016. Web.
