Please note: This information was current at the time of publication but now may be out of date. This handout provides a general overview and may not apply to everyone. 

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Am Fam Physician. 2006;73(4):665-666

See related articel on preterm premature rupture of membranes.

What is preterm premature rupture of membranes (PROM)?

During pregnancy, the word “membranes,” also called the “water bag,” refers to the sac that grows around the baby and protects it from germs. The water bag is a cushion for the baby and holds the fluid that helps the baby’s lungs grow. Preterm PROM is when the water bag breaks early—three weeks or more before the baby is due.

What happens if I have preterm PROM?

Sometimes the umbilical cord can get squeezed during preterm PROM, cutting off the blood flow to the baby. There also is a chance that germs can get into the uterus and cause an infection in you and the baby. Preterm PROM also can cause early labor and delivery, which may cause brain damage and problems with the baby’s lungs.

Who gets preterm PROM and why?

Preterm PROM is rare, and doctors don’t know what causes it. If you smoke, have had a sexually transmitted disease (STD), or have had preterm PROM in the past, you have a higher risk of getting preterm PROM. If you have had vaginal bleeding during pregnancy in the past, you are at higher risk of getting preterm PROM. Black women are two times as likely to get preterm PROM than white women. Being pregnant with twins or triplets can cause preterm PROM because the uterus becomes very big. Certain procedures also may result in preterm PROM, including cerclage (a stitch around the cervix to stop the baby from being born early) or amniocentesis (say: am-nee-oh-sen-TEE-sis) (a test that uses a needle to get some of the fluid out of the water bag).

How can my doctor tell if I have preterm PROM?

Patients with preterm PROM often report a sudden gush of fluid that keeps leaking. Some patients will wake up feeling wet or with fluid all over the bed. Sometimes they feel like they urinated on themselves or can’t stop the flow when they go to the bathroom. Patients often say that the fluid looks clear to light yellow.

Are there any tests my doctor will do?

If you notice any of these things during your pregnancy, call your doctor right away. It is important to let your doctor know if you have had any contractions (pains), vaginal bleeding, recent sex, or a fever. Your doctor will check to see if there is any fluid in your vagina. This exam also will let the doctor see if the cervix is opening.

Are there any other problems like preterm PROM?

Other problems that might be confused with preterm PROM include vaginal discharge or infections causing a discharge. The uterus of a pregnant woman pushes down on the bladder, causing urine to come out without warning. This also could be confused with preterm PROM.

How is preterm PROM treated?

Doctors base treatment on how far along your pregnancy is and if germs are present. Some patients with preterm PROM are placed on bedrest to try to decrease the amount of fluid lost. Your doctor also may give you medicine. If you are far enough along in pregnancy, your doctor may start labor.

How can I stop preterm PROM?

There is no sure way of stopping preterm PROM, but you can lower your risk by not smoking.

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