Can an ultrasound detect premature rupture of membranes?

Written by Zhang Lu
Obstetrics
Updated on September 16, 2024
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Premature rupture of membranes (PROM) refers to the rupture of amniotic fluid before labor. The most common diagnostic method for PROM is based on the clinical symptoms of the patient, mainly intermittent vaginal discharge. PROM can be confirmed using pH test strips specific for this condition. Ultrasound can be used as an auxiliary diagnostic method for PROM because most pregnant women with PROM will show a decreased amount of amniotic fluid during an ultrasound. However, the specificity of using ultrasound to determine PROM is not strong. Although the membranes may rupture, amniotic fluid can still be continuously produced, so some pregnant women may still have a normal amount of amniotic fluid during an ultrasound. Therefore, in most cases of PROM, a reduction in amniotic fluid can be observed through ultrasound, but there are cases where the amniotic fluid level appears normal. In such instances, it's essential to analyze the patient's clinical symptoms.

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Written by Zhao Li Li
Obstetrics
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Is the risk of infection high with premature rupture of membranes?

In general, after premature rupture of membranes, there is still a significant risk of intrauterine infection. Normally, after premature rupture of membranes, it is necessary to clearly determine whether the development size of the embryo inside the uterine cavity is mature, as well as the specific amount of premature rupture of membranes and vaginal discharge. If the rupture of membranes is severe and there is a large amount of amniotic fluid flowing out of the vagina, it generally may lead to a reduction in amniotic fluid and significantly increase the risk of infection. After confirming premature rupture of membranes, it is necessary to actively use antibiotics for symptomatic treatment to prevent infections, promote fetal lung maturity inside the uterine cavity, and reduce the risk of delayed lung function development in the fetus after childbirth.

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Written by Zhang Lu
Obstetrics
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Can premature rupture of membranes be detected?

Premature rupture of membranes refers to the rupture of membranes before labor, manifested as vaginal discharge and abdominal pain, among other symptoms. The diagnosis of premature rupture of membranes is primarily conducted through the following methods: First, based on the patient's symptoms. The most typical symptom of premature rupture of membranes is the discharge of clear fluid from the vagina. This can generally be identified as amniotic fluid by the naked eye, which helps in diagnosing premature rupture of membranes. Second, if the amount of vaginal discharge is minimal, PH test strips can be used for detection. A change in the PH strip may indicate a diagnosis of premature rupture of membranes. Third, an ultrasound can also generally assess premature rupture of membranes, as the amount of amniotic fluid will decrease when the membranes have ruptured. These methods combined can confirm the presence of premature rupture of membranes.

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Written by Yue Hua
Obstetrics and Gynecology
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Premature rupture of membranes requires what examinations?

To diagnose premature rupture of membranes, first, a pH test of the vaginal fluid must be conducted. The normal pH value of vaginal fluid in women ranges from 4.5 to 5.5, whereas the pH of amniotic fluid ranges from 7.0 to 7.5. If the membranes have ruptured prematurely, the pH value would be greater than 6.5. Additionally, a smear test of the vaginal fluid can be done by placing vaginal secretions under a glass slide and examining them under a microscope. If fern-like crystals are observed, this indicates the presence of amniotic fluid. Furthermore, an ultrasound examination can be conducted. If the ultrasound shows a rapid decrease in the amount of amniotic fluid, this can assist in the diagnosis.

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Written by Du Rui Xia
Obstetrics
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Can you still have a natural birth if the membranes rupture prematurely?

Whether a natural delivery is possible after premature rupture of membranes depends on the condition of the pregnant woman and the fetus. If the woman's pelvis is normal and there are no signs of intrauterine hypoxia in the baby, then a natural delivery can be conducted. If, during natural delivery, the baby shows signs of hypoxia or the woman's pelvic conditions are not favorable, a cesarean section should be performed promptly after the premature rupture of membranes. If delivery cannot be achieved naturally within 24 hours after the premature rupture of membranes, it is crucial to prevent infection.

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Written by Zhao Li Li
Obstetrics
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Can premature rupture of membranes lead to a vaginal delivery?

If symptoms of premature rupture of membranes occur, further examination is still necessary to determine the specific mode of delivery. If there is only an early rupture of the membranes without systemic infectious symptoms, a comprehensive assessment of the development size of the fetus inside the uterine cavity, the specific amount of amniotic fluid, and the condition of the birth canal should be conducted. If there are no abnormalities, it is possible to attempt vaginal delivery. During the trial of labor, it is also necessary to closely monitor the changes in the amniotic fluid and the condition of the fetal heart rate. If any abnormalities occur, there is also the possibility of switching to an emergency cesarean section at any time.