About the Premature Rupture of Membranes (PROM)

A woman’s water breaking is frequently the first indication that a baby is on its way.  There are many situations, however, where that moment signals specific responsibilities to the doctors to keep the baby safe.  The longer the time between rupture of membranes and delivery of the baby, the more likely that the pregnancy will be complicated by infection, like chorioamnionitis.

Definitions

    • Rupture of Membranes (ROM):  usually diagnosed by leaking of fluid from the vagina, however there are three tests that can confirm ROM (pool, fern and nitrazine tests)
      • Premature Rupture of Membranes (PROM):  rupture of the membranes surrounding the fetus by at least one hour before labor
        • Preterm Rupture of Membranes:  rupture of the membranes surrounding the fetus before 37 weeks
          • Preterm Premature Rupture of Membranes (PPROM):  a combination of PROM and Preterm ROM; rupture of the membranes surrounding the fetus both before labor and before 37 weeks
            • Prolonged Premature Rupture of Membranes (Prolonged PROM):  rupture of the membranes surrounding the fetus by at least 18 hours before labor

            Medical Treatment

            Rupture of membranes before 37 weeks can cause preterm labor and delivery, and chorioamnionitis (an infection that can cause cerebral palsy).  Untreated, 50% of patients will go into labor within 24 hours, and 75% will go into labor within 48 hours.  Even though more time in the womb is important for continued development, PPROM may increase the risk of choriamnionitis, placental abruption and cord prolapse.

            To determine whether preterm rupture of membranes has occurred, the physician should talk with the expectant mother, and possibly perform additional testing.  If those tests are inconclusive, an ultrasound may show the level of amniotic fluid to determine if rupture has occurred.

            When chorioamnionitis is a concern, the mother’s temperature and white blood count should be closely tracked, the mother should be evaluated for uterine tenderness, and the fetal heart rate tracings should be monitored closely.

            Treatment depends on the age of the baby.  The two factors that the doctor must weigh are the risks of prematurity versus the risks of infection.  Typically, before 32 weeks the baby will benefit from more time in the womb; after 36 weeks the baby should be delivered, and from 32 to 36 weeks can be a more complicated decision, and will depend on the developmental stage of the baby.

            Antibiotics like ampicillin can help to prevent the period before labor.  PPROM occurs in three percent of pregnancies, and causes one-third of all preterm deliveries.

            Rupture of Membranes:  Injuries Caused By Improper Management

            There are many complications that can result from improper management of rupture of membranes at all stages.  Some of the most common are:

              • respiratory distress syndrome
                • neonatal sepsis

                Contact Us

                If your water broke and your baby has medical injuries, either because he was premature, suffered an infection, placental abruption, umbilical cord prolapse or cerebral palsy, contact our medical malpractice lawyers at (855) 712-7818 or fill out our online contact form for a free evaluation.

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