Under what circumstances does premature rupture of membranes occur?

The article was consulted by Specialist Doctor I Pham Thi Yen - Obstetrics and Gynecology Department - Vinmec Hai Phong International General Hospital

Premature rupture of membranes (PROM) is the rupture of membranes before the onset of labor. If there are no signs of labor after an hour of water breaking, it is called preterm water rupture.
According to statistics, about 8% - 10% of pregnant women experience premature rupture of membranes, accounting for 1⁄4 of the causes leading to premature birth.

Amniotic fluid begins to form around the 12th day after conception. The fetus is located in the uterus and is surrounded by amniotic fluid. This is the environment that contains nutrients, it has the ability to regenerate and exchange, plays an important role in determining the survival and development of the fetus. In addition, the amniotic sac also functions as a cushion to protect the fetus from collisions and trauma, ensuring a sterile environment for the baby to develop. When a pregnant woman enters the stage of labor, the amniotic membrane breaks down, the oily nature of the amniotic fluid has the function of lubricating the mother's genital tract, making it easier for the fetus to be born.
Because the amniotic sac plays a very important role, premature rupture of membranes when the fetus is not enough weeks old can have different consequences, depending on the maturity of the fetus. The most common are:

Infection due to premature rupture of membranes The environment in the amniotic sac is a sterile environment, which protects the fetus from the invasion of bacteria. When the amniotic membrane breaks and the amniotic fluid leaks out, this protective barrier also loses its effectiveness. At this time, bacteria from the outside can enter the amniotic sac and cause damage to the fetus, leading to bacterial infections such as amniotic infection, neonatal infection or postpartum infection. Amniotic fluid infection occurs when the fetal position is not stable, which can lead to prolapse of the umbilical cord, and there are even cases of complications leading to umbilical cord loss, causing the fetus to no longer receive nutrition and oxygen. In addition, when the fetus is infected, there is a high risk of respiratory failure at birth. If there is the presence of bacteria that cause lower genital tract infections such as Neisseria gonorrhea, group B streptococcus, .. ..then the risk of uterine infection will increase.
Premature birth When premature rupture of membranes occurs with infection and complications, doctors will appoint a caesarean section to have a cesarean section. If a baby is born before 37 weeks of age, there are often long-term health risks such as respiratory problems, vision problems or infections. In cases where a baby is born before the 24th week of pregnancy, there is usually not much chance of survival. In addition, if premature rupture of membranes leads to premature labor, premature babies will also face the same risks because at this time, the functions of the baby's body are not really perfect.

Cases in which pregnant women may experience premature rupture of membranes are:
Placenta previa Placenta previa is a phenomenon where the placenta is located at the lowest position of the uterus, then the placenta will cover part or all of the neck. uterus. The most common symptom of placenta previa is abnormal vaginal bleeding. This is one of the causes of premature rupture of membranes in pregnant women.
Polyhydramnios, multiple pregnancy Polyhydramnios is a condition in which the amount of amniotic fluid increases to an excess. Usually, it is diagnosed when the amount of amniotic fluid increases to 2000ml or more. As the amount of amniotic fluid increases rapidly, pregnant women will feel increasingly heavy and uncomfortable. The earlier polyhydramnios appears and the more amniotic fluid, the more dangerous the complications. When the amount of amniotic fluid in the uterus is too high, it will lead to premature rupture of membranes.
Multiple pregnancy is a phenomenon in which a woman has more than one fetus in her uterus at the same time. Usually, having a multiple pregnancy is the happiness of many mothers. However, pregnant women with multiples need to be careful because the rate of pregnancy complications will be higher than that of other normal pregnant women. Among them, premature rupture of membranes leading to premature birth is a common condition. According to statistics, more than 50% of twins are born prematurely, and almost all triplets have the same condition.
Cleft uterus Normally, the waist and cervix will be closed, it only opens during menstruation to help the menstrual flow out. During pregnancy, the isthmus and cervix will always be closed, only during labor will the cervix open to allow the baby and other fetal appendages to come out.
Cleft palate is a condition in which the cervix opens during pregnancy, before labor. When the pregnancy is over 16 weeks old, the pressure in the amniotic sac increases, the impact on the cervix makes the cervix gradually dilate, leading to premature rupture of membranes. The result is miscarriage or premature birth.
Abnormal fetal position The fetal position is understood as the position of the fetus relative to the mother's cervix. Usually, the first position (or the right position) is considered the most favorable position for childbirth. First position means that the baby's head will be towards the vulva, the bottom of the baby will be towards the mother's chest. At birth, the baby's head will come out first, the baby's limbs will go back.
In addition to the first position, there is also the butt position (or the reverse position) and the horizontal position. These are abnormal fetal positions, causing many dangers to both mother and baby. Pregnant women with abnormal pregnancy need to regularly monitor the status of the fetus, should rest in the last three months of pregnancy to avoid premature rupture of membranes, causing premature birth or danger to the baby.

When premature rupture of membranes, mothers will have the following signs:
There is an abnormal discharge in the vagina, especially when using tampons, there is still a wet white discharge with a fishy smell. When the amniotic sac breaks, the pregnant woman can feel the "poop" sound and the amniotic fluid begins to overflow from the intimate area, in some cases the amniotic fluid will leak little by little, so many people do not distinguish the sign. This is associated with urinary incontinence. Mothers should pay attention to monitor the body's changes in the last three months of pregnancy to promptly detect and treat if premature rupture of membranes occurs.
Vinmec International General Hospital offers a Package Maternity Care Program for pregnant women right from the first months of pregnancy with a full range of antenatal care visits, periodical 3D and 4D ultrasounds and routine tests to ensure that the mother is healthy and the fetus is developing comprehensively.
Pregnant women will be consulted and checked for health under the close supervision of experienced and specialized Obstetricians, helping mothers have more knowledge to protect their health during pregnancy as well as reduce reduce complications for mother and child.