Prelabor Rupture of Membranes (PROM)

Condition Basics

What is prelabor rupture of membranes (PROM)?

Before a baby is born, the amniotic sac breaks open. This causes amniotic fluid to either leak slowly or gush out. It's often called "having your water break." When this happens before contractions start, it is called prelabor rupture of membranes (PROM).

PROM can occur at any time during pregnancy before labor begins. Early PROM can happen before 37 full weeks of pregnancy. Then it's called preterm prelabor rupture of membranes, or pPROM.

Smoking while pregnant increases the risk of PROM.

What causes it?

PROM is typically unexpected, and the cause is often difficult to identify. Known causes of PROM include:

  • Infection of the uterus.
  • Overstretching of the uterus. This can be caused by a multiple pregnancy (a pregnancy of two or more babies). It can also be caused by an excess of amniotic fluid. Amniotic fluid is the liquid that surrounds a developing baby.
  • Trauma, such as from a vehicle accident.

What happens when you have PROM?

  • Labor usually starts soon after PROM. If it doesn't, your doctor may induce labor (use medicine to start it).
  • The amniotic sac protects the baby from infection. After the sac is torn, the risk for infection is much higher. If you think your sac has broken open, avoid letting anything enter your vagina. Don't have sex or flush your vagina with fluid (douche).
  • After the sac ruptures, the baby moves down into the pelvis. The baby may press on the umbilical cord. This is not common, but it can cut off the baby's oxygen and blood supplies. In that case the baby must be delivered quickly.

How is PROM treated?

Your doctor will probably have you go to the hospital. If labor doesn't start in 12 to 24 hours, your doctor may want to induce. If your doctor is worried about infection, you may be given antibiotics.

How is medicine used to treat preterm labor?

If your contractions are causing changes in your cervix, or if you have signs of infection or preterm prelabor rupture of membranes (pPROM), you may be given medicines to help delay delivery.

Delaying labor even for a short time can allow you to be:

  • Moved to a medical center that has a neonatal intensive care unit (NICU).
  • Given medicine to speed up lung development, which takes at least 48 hours to fully benefit the baby's lungs. Even 24 hours provides some benefit.

Medicines that may be used to treat preterm labor include:

  • Antibiotics to prevent or treat infection.
  • Antenatal corticosteroids, to help prepare the fetus's lungs for preterm birth.
  • Tocolytic medicines, to stop preterm labor. Examples include:
    • Terbutaline.
    • Indomethacin.
    • Nifedipine.
    • Magnesium sulfate. If you're less than 32 weeks pregnant, your doctor or nurse-midwife may give you this medicine to help prevent some problems that affect your baby's brain, such as cerebral palsy.

Certain tocolytic medicines can be dangerous when a fetus is showing signs of distress or for women with certain health conditions (such as heart problems, severe preeclampsia, or poorly controlled diabetes or high blood pressure).

Credits

Current as of: June 16, 2021

Author: Healthwise Staff
Medical Review:
Sarah Marshall MD - Family Medicine
Adam Husney MD - Family Medicine
Kathleen Romito MD - Family Medicine
Kirtly Jones MD - Obstetrics and Gynecology
Heather Quinn MD - Family Medicine