Premature Rupture of Membranes
by Susan L. Madden, MS and Rebecca J. Stahl, MA
Premature rupture of membranes (PROM) is the breaking of the amniotic sac before labor begins. The sac contains amniotic fluid and the developing baby. With PROM, the amniotic fluid inside the sac leaks or gushes out of the vagina. This is also known as your water breaking.
PROM occurs during the third trimester after 37 weeks of gestation. A related condition called preterm premature rupture of membranes (PPROM) occurs before 37 weeks of gestation.
Call your doctor right away if you suspect that your water has broken.
The causes of PROM are not clearly understood. Some of the possible causes are:
Risk Factors TOP
Factors that may increase your chance of PROM include:
The main symptom of PROM is fluid leaking from the vagina. You may experience a sudden gush of fluid or a slow, constant trickle. It can be difficult to distinguish between a slow amniotic trickle or urine. Your doctor can do simple tests to determine this.
Symptoms include a fever above 100.5ºF (38ºC). If you have any of these symptoms, call your doctor right away.
Complications from PROM may include:
If a large amount of fluid is leaking from the vagina, diagnosing PROM can be straightforward. To confirm the diagnosis, the doctor may do the following tests:
The doctor will also check you for fever and other signs of infection. He will monitor your baby for any signs of distress.
Labor usually begins within hours after PROM. If labor does not begin soon after your water breaks, the risk of infection increases. In many cases, labor will be induced by giving you medications. Antibiotics may also be given.
You and your baby will be watched closely to look for signs of any problems developing. For example, your baby’s heart rate will be monitored.
American Pregnancy Association
National Institute of Child Health and Development
About Kids Health
The Society of Obstetricians and Gynaecologists of Canada
ACOG Committee on Practice Bulletins-Obstetrics. ACOG Practice Bulletin No. 80: premature rupture of membranes. Clinical management guidelines for obstetrician-gynecologists. Obstet Gynecol . 2007;109(4):1007-1019. Reaffirmed 2012.
Placental abruption. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php . Updated February 14, 2013. Accessed August 1, 2013.
Premature rupture of membranes: causes, risks, and treatment. Pregnancy Info website. Available at: http://www.pregnancy-info.net/prom.html . Accessed August 1, 2013.
Premature rupture of membranes at term (term PROM). EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php . Updated February 5, 2013. Accessed August 1, 2013.
Last reviewed August 2013 by Andrea Chisholm; Brian Randall, MD
Last Updated: 5/11/2013