What is premature rupture of membranes and how dangerous is it?

The article was professionally consulted by Specialist Doctor Obstetrician and Gynecologist - Department of Obstetrics and Gynecology - Vinmec Hai Phong International General Hospital. The doctor has many years of experience in the field of obstetrics and gynecology.

The amniotic sac is the environment to protect and nourish the fetus, help the fetus absorb nutrients and protect from external influences. If for some reason the amniotic sac breaks before 37 weeks of pregnancy, it is called preterm rupture of membranes.

Preterm rupture of membranes is the spontaneous rupture of membranes and chorion at any point prior to labor.

The amniotic sac is the place to protect and nourish the fetus. The phenomenon of premature rupture of membranes in different cases in different periods will cause different complications and effects.

The more preterm the fetus, the longer the latency period, the majority of adult fetuses will go into spontaneous labor within 24 hours. However, 50% of cases of rupture of membranes after 37 weeks will go into labor within 5 hours. If water breaks at 32 - 34 weeks, an average of 4 days after labor will occur and 93% of cases will deliver within 1 week.
If the premature rupture of membranes lasts for a long time, it can:
Cause amniotic fluid infection, postpartum infection, neonatal respiratory failure, neonatal infection. Low amniotic fluid leads to fetal lung hypoplasia, limb deformity, umbilical cord compression. Placental abruption, which can lead to fetal death in utero.

The cause of premature rupture of membranes may be due to factors that hinder the adjustment of the fetal position including:
Abnormal fetal position: transverse position, breech position, high head position Narrow pelvis Placenta previa Multiple pregnancy. Polyamniotic fluid. The cause of this phenomenon is also due to uterine isthmus, inflammation of the membranes (usually due to infection of the vulva and vagina). When the water breaks, labor will be stimulated to bring the baby out. If because the fetus is not yet full week, no labor occurs can lead to infection of the amniotic fluid, causing infection of the fetus.
If the water breaks, the baby won't be able to live. Because as mentioned above, the amniotic sac is the environment that nourishes and protects the fetus from external influences.

The phenomenon of premature rupture of membranes at different stages of the fetus will have different specific treatments:
4.1 Pregnancy 22 - 31 weeks: The pregnant mother tries to maintain the pregnancy In addition, the doctor will conduct injections fetal lung wall (Intramuscular Betamethasone 12mg/24 hours x 2 days or Dexamethasone 6mg/12 hours x 2 days). This treatment can reduce fetal weight loss, head circumference and body length.
Management of infection by:
Cervical, vaginal, anal cultures. Use of broad-spectrum antibiotics prevents infection for both mother and fetus, in addition to reducing labor rates. Therefore, it is recommended for routine use in cases where it is necessary to prolong the pregnancy when the membranes have ruptured prematurely to stimulate fetal lung maturation. Currently, studies agree that antibiotic use should not exceed 7 days, because prolonging the duration of antibiotic use in these pregnancies is not necessary, but also increases antibiotic resistance of bacteria.
In addition, doctors also monitor mother and fetus and use tocolytic drugs.
4.2 For fetuses 32 – 33 weeks of age Doctors will determine the health status of the fetus at the time of admission.
Monitor fetal heart rate at hospital admission. Identify intrauterine growth retardation. Fetal lung maturation corticosteroids Infection management. Use tocolytic drugs for pregnant women, and will initiate labor when there is enough evidence of signs of lung maturity, infection, fetal distress. 4.3 Fetal from 34-36 weeks Doctors will conduct to determine the health status of the fetus at the time of receiving.
Most women will go into labor spontaneously within 24 hours of their water breaking. It may be waiting for spontaneous labor or induction of labor depending on the status of amniotic fluid, pregnancy and infection. If there is sufficient evidence of lung maturity, terminate the pregnancy immediately.
4.4 For fetuses over 37 weeks, the doctor will proceed to terminate the pregnancy depending on the condition of the cervix, fetal position, fetal status, infection or not.
If there is evidence that the fetus cannot withstand labor, doctors will perform a cesarean section. If there is clinical evidence of infection and there are no contraindications to vaginal delivery, give antibiotics and induce labor.
When the cervix is ​​favorable, the doctor will induce labor with oxytocin infusion. Conversely, if the cervix is ​​not favorable, the doctor will conduct cervical ripening. Low birth weight preterm infants will be transferred to the low birth weight preterm infant care unit.
Department of Obstetrics and Gynecology - Vinmec International General Hospital has solved many difficult cases such as: premature rupture of membranes, placenta accreta, knotted umbilical cord, preterm pregnancy... To make the pregnancy process more convenient, Vinmec has deployed PACKAGE Maternity packages, including prenatal, intrapartum and postpartum care services. Pregnant women are monitored and carried out all necessary tests and ultrasounds to detect pregnancy abnormalities early.
Vinmec International General Hospital gathers a team of highly qualified doctors at home and abroad as well as the quality of ultrasound machine system, modern equipped medical equipment, main prenatal examination procedures. Accurately, science will handle abnormalities during pregnancy and labor quickly, helping women have the safest pregnancy.