PPROM: Preterm Premature Rupture of Membranes
If you’re expecting, you may wonder when your water will break, where you’ll be, and if it will happen unexpectedly or too early. Premature Rupture of Membranes (PROM) is a condition that happens during pregnancy when the membranes of the amniotic sac break at least an hour before labor starts. If this happens before 37 weeks of pregnancy, then the condition is called Preterm Premature Rupture of Membranes (PPROM).
To put your mind at ease, here are some helpful facts and figures about PROM and PPROM:
- PPROM happens in only 150,000 pregnancies each year, and this translates to less than three percent
- Only 15 percent of pregnant women have PROM—the water breaks about one hour to 18 hours (“prolonged” PROM) before labor starts
- PROM, the rupture of the membranes just before the onset of labor, typically initiates labor and there is no extra intervention needed
Why Membranes Rupture
The possible reasons membranes may break early are plentiful. PROM may be associated with factors ranging from sexually transmitted infections to lower socioeconomic conditions (women in such situations may be less likely to get adequate prenatal care).
On the other hand, PPROM usually has different causes and outcomes. While PROM is a variation of the normal 40-week gestation that precedes labor by about an hour or so and generally not serious, PPROM typically is caused by a uterine infection and is quite dangerous. It is more serious than PROM, as it most often triggers an early delivery.
Why PPROM Occurs
Any number of things may contribute to PPROM, including:
- Infections of the uterus, cervix or vagina
- Excess stretching of the amniotic sac (due to a large amount of fluid or multiple babies exerting pressure on the membranes)
- Poor diet and/or inadequate hydration
- Excessive smoking
- Recent surgery (or other procedure) of the cervix
- Premature rupture of membranes with a previous birth
Other clinical factors linked with PPROM are:
- Low BMI (body mass index)
- Vaginal bleeding during pregnancy
- Weak cervix (incompetent cervix) that opens early
- Inflammation or weakening of the membranes
- Early contractions
Signs of Your Water Breaking
If your membranes rupture when you’re going about your day, the fluid usually comes out as a slow leak—rather than a giant gush.