The membranes that hold the amniotic fluid usually break early in labor. If your water breaks before then, this is called premature rupture of the membranes (PROM).
One in 10 pregnant women experience it, usually just hours before contractions begin, though it can occur weeks or months before your due date. When PROM occurs before 37 weeks of pregnancy, it's referred to as preterm PROM; about 1 to 3 percent of women develop it. One sign that your water has broken is when fluid trickles or gushes from your vagina.
PROM's causes aren't thoroughly understood, but taking certain steps may help reduce your risk. Smoking increases the risk of PROM, so quit now. Get early, regular prenatal care so that certain complications of pregnancy that increase the risk of PROM, such as uncontrolled high blood pressure, can be detected and treated. You also are at increased risk of PROM if you are pregnant with twins (or a higher number of multiples).
Your doctor probably will tell you to go to the hospital so that she can examine you and perhaps do tests to confirm that your membranes have ruptured. You'll likely go into labor within hours (and deliver a healthy baby), but a few women who have PROM near their due date don't go into labor. Because the risk that the amniotic fluid (and perhaps the fetus) will become infected increases after the membranes have been ruptured for 24 hours, your doctor may decide to induce labor after you experience PROM.
If you develop PROM at 34 to 37 weeks gestation and tests show that your baby's lungs are mature, your doctor may recommend inducing labor. Babies born at this stage usually have no serious complications resulting from preterm birth.
If you suffer from preterm PROM, you'll probably need to stay in the hospital where you and your fetus can be monitored for signs of infection or labor. Your doctor will focus on preventing preterm delivery. You probably will be treated with antibiotics, which not only can prevent infection but also appear to help delay delivery and reduce the risk of respiratory distress and other serious complications in premature newborns. Your doctor may recommend treatment with corticosteroids as well.
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