PROM

Premature rupture of the membranes, better known as PROM, is a condition in which your water breaks after 37 weeks of pregnancy, but labour does not begin for at least another hour. The membranes which rupture are the amniotic sac and its chorion, the same two membranes that normally rupture with the onset of labour.

Symptoms of PROM include:

• leakage of fluid
• vaginal discharge
• vaginal bleeding
• pelvic pressure

These are all associated with real labour, but they are not accompanied by contractions. However, it is important that you go to the hospital immediately, because your fetus will need to be monitored. PROM is usually diagnosed using a vaginal examination of the cervix and vaginal cavity and then confirmed by an ultrasound.

PROM occurs in about 10% of all pregnancies and of that 10%, 90% of women will naturally go into labour by the time 24 hours passes. This means it’s very rare for PROM to result in great complications. However, if you and your doctor choose to monitor the fetus rather than induce labour (the two treatment options for PROM), there are some risk factors including:

• infection
• chorioamnionitis
• placental abruption
• fetal distress
• fetal restriction deformities
• pulmonary hypoplastia
• umbilical cord prolapse
• fetal death (but this is only in 1% of all PROM cases)

When it comes to deciding between induced labour or expectant management (monitoring your baby), different doctors prefer different methods, but it is usually the mother’s choice. So ask your doctor what the hospital’s policy is. However, induced labour is your best option once 24 hours has elapsed for both you and your baby’s health as the above risk factors significantly increase after that threshold.