𝐖𝐡𝐚𝐭 𝐝𝐨𝐞𝐬 𝐢𝐭 𝐦𝐞𝐚𝐧 𝐭𝐨 𝐡𝐚𝐯𝐞 𝐩𝐫𝐞𝐦𝐚𝐭𝐮𝐫𝐞 (𝐩𝐫𝐞𝐥𝐚𝐛𝐨𝐮𝐫) 𝐫𝐮𝐩𝐭𝐮𝐫𝐞 𝐨𝐟 𝐦𝐞𝐦𝐛𝐫𝐚𝐧𝐞𝐬?

1)      What does it mean?

It means spontaneous rupture of membranes before the onset of regular uterine contractions. When it occurs before 37 weeks, it is referred to as preterm prelabor rupture of the membranes (PPROM). When it occurs at or after 37 weeks, it is referred as term prelabor rupture of membranes (Term PROM). The diagnosis of PROM is based upon a characteristic history (ie, leaking fluid per vagina) and speculum examination (ie, visualization of fluid flowing from the cervical os), supplemented by diagnostic testing of fluid in the posterior fornix, if the diagnosis is uncertain.

2)      How does it look and feel?

It (Amniotic fluid-your “water”) is usually clear, but also can be yellow, pink-tinged, brown or green.

Pregnant woman may feel sudden gush of water through vagina or trickling of fluid through vagina along with wetting of undergarments with odourless, colourless fluid.

3)      What is the exact experience that a woman goes through when her water bursts?

Most women especially who are becoming mother for the first time misinterpret it as leaking of urine and may get confused what is happening. Especially if the gestation is < or = 7 months then the mother feels stressed or frightened that what is happening with her. She may or may not consult the doctor immediately. But the women who are in their second or third pregnancies are aware about this condition and consult the doctor on time.

4)      What should a woman do after she realises that her waters have burst?

Amniotic sac and fluid play an important role in the labour and usually remain intact until the end of labour. However, around 10% of women will experience their waters breaking before labour begins.

When a woman experiences the water burst or leaking per vagina, first she has to take a sanitary pad and then should consult the treating doctor immediately.

5)      When does the actual delivery take place after the waters burst?

There is no exact time of delivery but it is preferred to have delivery as soon as possible depending upon the gestation and baby’s condition and the amount of amniotic fluid left behind.

When the water bursts, the time and mode of delivery depends upon the gestational age. If the gestation is less than 26 weeks, conservative treatment is given to stretch the pregnancy beyond 32 weeks if possible. For this, your Gynecologist will assess the condition of baby and mother and then will take the decision accordingly.

If the gestation is > 32 weeks, your doctor will decide whether to go for vaginal delivery or caesarean delivery of the baby keeping baby’s health in mind.

If everything is within normal limits, then doctors prefer normal vaginal delivery.

If along with leaking, the labor pains start then cervical dilatation may lead to normal delivery. In this condition, the time of delivery depends upon gestation.

So the doctors always keep baby’s health in forefront while handling this condition.

6)      What complications can arise in this process? How can a woman treat them as well as prevent them?

Complications-

1. When leaking or water burst occurs at or after 37 weeks of completed gestation (at term), there is minimal risk to the fetus and labor typically starts soon after spontaneously.
2. If leaking or water burst occurs before 37 weeks, called preterm premature rupture of membranes (PPROM), the fetus and mother are at greater risk for complications.
3. PPROM causes one-third of all preterm births and babies born preterm (before 37 weeks) can suffer from the complications of prematurity, including death.
4. The leakage provides a path for bacteria to enter the womb and puts both the mother and fetus at risk for life-threatening infection.
5.  Low levels of fluid around the fetus also increase the risk of the umbilical cord compression and can interfere with lung and body formation in early pregnancy.

7)      Are there any exceptions to the rule?

Ongoing research trials based on evidence also lets these women fall into one group (control group), where no intervention (augmentation of labour or administering prophylactic antibiotics) is done despite leaking of waters.