Preterm premature rupture of membranes (PPROM) is when the amniotic sac breaks before 37 weeks of pregnancy and labor has not started within 1 hour. The sac holds amniotic fluid and the growing baby. In PPROM, the fluid in the sac leaks or gushes out of the birth canal. This is also known as your water breaking.
Fetus in the Amniotic Sac
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Call your doctor right away if you think that your water has broken.
PPROM is caused by membranes that are weak or thin.
Factors that may raise your risk are:
The main symptom of PPROM is fluid leaking from the birth canal. You may have a sudden gush or a slow trickle. It can be hard to tell a slow amniotic trickle apart from urine. Your doctor can do tests to find out.
PPROM raises the risk of infection. You may also have:
If a large amount of fluid is leaking from the birth canal, PPROM is likely.
You may also have these tests:
An ultrasound may be done to see how much fluid you have.
Treatment depends on when it happens in the pregnancy.
The doctor will:
The doctor will treat you with antibiotics and steroids. The doctor may try to put off delivery until 33 weeks of pregnancy.
The doctor may admit you to the hospital for bed rest and to monitor you and your baby. 24 weeks is about the youngest a baby can be born. The doctor will talk to you about the risks and benefits of your options.
There is no way to prevent PPROM.
American Pregnancy Association
National Institute of Child Health and Development
The Canadian Women's Health Network
The Society of Obstetricians and Gynaecologists of Canada
ACOG Committee on Practice Bulletins-Obstetrics. ACOG Practice Bulletin No. 160: premature rupture of membranes. Clinical management guidelines for obstetrician-gynecologists. Obstet Gynecol. 2016 Jan;127(1):192-194.
Jeffcoat MK, Hauth JC, Geurs NC, et al. Periodontal disease and premature birth: Results of a pilot intervention. J Periodontology. 2003;74(8);1214.
Preterm premature rupture of membranes (PPROM). EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T435299/Preterm-premature-rupture-of-membranes-PPROM . Updated August 4, 2016. Accessed August 9, 2018.
Last reviewed May 2018 by
EBSCO Medical Review Board
Beverly Siegal, MD, FACOG
Last Updated: 8/9/2018