Term pre labour rupture of membranes
Term pre labour rupture of membranes (Term PROM)
The information in this brochure refers to the care of women and babies where the membranes have ruptured after 37 weeks of pregnancy. About one in 10 women giving birth will have Term PROM. For most women, labour will start within 24 hours of their membranes rupturing. However for some women, labour may not start for several days.
Term PROM is when the membranes, or bag of waters, surrounding your unborn baby break, or begin to leak, before labour begins. Occasionally this can happen very early in a pregnancy and this is called Preterm Pre labour Rupture of Membranes (PPROM). This is a more complicated condition and is discussed in a separate brochure.
Diagnosis of Term PROM
Your doctor or midwife will ask you about the symptoms you have experienced. In addition they may do one of the following:
- examine your cervix—this may show fluid leaking from the cervical opening
- ultrasound scan—this may show reduced fluid around your baby. This would be expected if your membranes had ruptured.
Your options for care
If you have Term PROM, you have two options.
Early induction of labour
Induction of labour encourages your contractions to start. A synthetic hormone called oxytocin is used to do this. It will be given to you through an intravenous infusion (drip) inserted into the back of your hand.
Early induction of labour is encouraged, because it reduces the risk of infection for you and your baby. It also reduces the chance of your baby requiring admission to a neonatal unit. Some women may find induced labour to be more painful and you may need stronger pain relief, such as an epidural. Women who elect induction of labour are no more or less likely to give birth by caesarean section or with the help of an instrument (forceps or vacuum).
Expectant care—awaiting the onset of labour
Waiting for labour to start naturally is another option, and is an appropriate choice in many circumstances. You will usually be able to go home to wait for labour to begin. Waiting for labour to start naturally does carry an increased risk of infection for you (risk of infection 6.7 per cent compared with 4.3 per cent for early induction) and your baby (2.3 per cent compared with 1.6 per cent) and an increased likelihood that antibiotics will be needed. These antibiotics will be given through an intravenous infusion (drip) in hospital. As the risks of infection are higher with expectant management, your baby may require observation and/or treatment in the neonatal unit.
At home you will need to record the following observations, including the date and time, in the booklet given to you by your doctor or midwife:
- your temperature, every four hours, while awake
- your pulse rate, every four hours, while awake
- your baby’s movements— expect about 10 or more movements in 12 hours
- your vaginal loss—colour, amount and odour
- your general wellbeing.
If you have chosen expectant management and have not come into labour naturally, then we would ask that you return for review again in 24 hours. It is very important that you contact the Pregnancy Assessment and Observation Unit immediately on 07 3163 1379 or 07 3163 2785 if you observe any of the following:
- temperature stays above 37.5°C
- pulse rate above 100 beats per minute
- change in colour or odour of vaginal loss
- vaginal bleeding or spotting
- abdominal cramping, pain,or contractions
- flu-like symptoms or feeling generally unwell
- decreased fetal movements.
It is likely that you will continue to leak fluid until the birth of your baby. Ways in which you can help prevent an infection include:
- changing your sanitary pads at least every four hours. Personal hygiene is very important to reduce the risk of infection
- not using tampons
- wiping from front to back after going to the toilet
- not going swimming
- not having baths or using a spa—please shower
- not taking part in any form of sexual activity
- not using any vaginal medications or creams.
It is important to remember that Term PROM is a relatively common problem in pregnancy and the risk of infection from Term PROM is low.
© 2010 Mater Misericordiae Ltd. ACN 096 708 922.
Mater acknowledges consumer consultation in the development of this patient information.
Last modified 12/11/2015.