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Obstetrics and Gynecology

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Preterm Ruptured Membranes

What are preterm ruptured membranes?

Preterm rupture of membranes occurs when the membranes surrounding the fetus spontaneously rupture prior to 37 weeks of pregnancy resulting in leakage of amniotic fluid. Once the membranes rupture, the fetus loses some of its protection from outside the uterus and the fetus is exposed to several serious risks. There is significant risk for preterm delivery with complications of immaturity of the infant's lungs, intestines, brain, and other organs, infections, learning disabilities, cerebral palsy, and neonatal death. Other risks include intrauterine infection, compression of the umbilical cord, and fetal distress. The women is at increased risk for cesarean delivery.

What causes preterm ruptured membranes?

Most of the time, the cause for premature rupture of membranes is not known, but risk factors that could play a role include infections of the uterus, cervix or vagina, excessive stretching of the amniotic sac from too much fluid or more than one baby putting pressure on the membranes, smoking, recent surgeries or biopsies of the cervix, and a history of premature rupture in earlier pregnancies.

What are the symptoms of preterm ruptured membranes?

The main symptom is fluid leaking from the vagina, which may leak slowly or gush out. Since the fluid is sometimes mistaken for urine, wear a feminine pad to absorb some of the fluid, then look at it and smell it – amniotic fluid has no color and does not smell like urine. If you feel your membranes have ruptured, call your health care provider immediately to get checked as soon as possible.

How are preterm ruptured membranes diagnosed?

If your membranes rupture, you should go the hospital where your health care provider will check your cervix and a sample of the fluid coming from your vagina will be tested in the lab to confirm that it is amniotic fluid. If it is, depending how far along you are in the pregnancy, you will be admitted to the hospital, likely until your baby is born.

What is the treatment for preterm ruptured membranes?

Depending upon how far along the pregnancy is, different management decisions will be made in discussion with the patient. Antibiotics are administered to reduce the risk of infection. As with other conditions with risk for early delivery, treatment options include corticosteroids to help mature the lungs and other organs, and magnesium sulfate to help decrease the chance of cerebral palsy. With ruptured membranes, the woman is usually hospitalized through the remainder of the pregnancy with daily fetal well-being monitoring. Pregnancy doesn't extend beyond 34 weeks. The infant may need to be admitted to the Neonatal Intensive Care Unit and cared for by our neonatologists and specialized nursing staff.