How is premature rupture of membranes diagnosed?

Written by Zhang Lu
Obstetrics
Updated on November 03, 2024
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Premature rupture of membranes refers to the rupture of the membranes before labor, with amniotic fluid leaking intermittently. For the diagnosis of premature rupture of membranes, the following methods are primarily used. First, through the symptoms of the patient, when the membranes rupture prematurely, a clear liquid intermittently leaks from the vagina. However, this liquid must be distinguished from vaginal secretions and urine. Second, judgement can be made based on the presence of fern-like crystals in the amniotic fluid. A small amount of the liquid can be taken and observed under a microscope, and if distinct fern-like crystals are observed, it can be concluded that there is premature rupture of membranes. Third, the use of premature rupture of membranes test strips can aid in diagnosis. If the test strip changes color upon contact with the leaking fluid, it can be definitively diagnosed as premature rupture of membranes. Fourth, ultrasound can serve as a supplementary method, as amniotic fluid often decreases with premature rupture of membranes, and an ultrasound can reveal amniotic fluid levels below the normal range.

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Written by Zhang Lu
Obstetrics
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Premature rupture of membranes symptoms

Premature rupture of membranes, as the name implies, refers to the clinical symptoms caused by the rupture of the amniotic sac before labor. These symptoms include the following aspects. First, there will be a leakage of amniotic fluid from the vagina, manifesting as wet pants or a wet bedsheet, which is a primary indication of premature rupture of membranes. Second, when the membranes rupture prematurely, there is often a small amount of bloody show. This is mainly because there are small capillaries on the membranes that also bleed when the membranes rupture, causing blood to mix with the amniotic fluid. Third, premature rupture of membranes often is accompanied by significant contractions, as the increase in pressure within the amniotic cavity during contractions can cause the membranes to rupture. When these situations occur, it is important to promptly go to the hospital to undergo an ultrasound and gynecological examination to confirm whether there is a premature rupture of membranes.

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Written by Zhao Li Li
Obstetrics
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Can you walk with premature rupture of membranes?

In general, if premature rupture of membranes has already occurred, it is normally necessary to rest, avoiding standing and walking. Premature rupture of membranes mainly refers to the situation where the water breaks before the onset of labor pains. This means that the membranes have ruptured and amniotic fluid may leak out at any time. Standing or walking can easily lead to continuous leakage of amniotic fluid, resulting in a reduction of the fluid or prolapse of the umbilical cord due to the leakage. If the prolapsed umbilical cord causes compressive symptoms, the fetus can quickly die within the uterine cavity. Therefore, after confirming premature rupture of membranes, it is necessary to rest in bed with the buttocks elevated and closely monitor specific fetal heart changes.

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Written by Du Rui Xia
Obstetrics
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Is premature rupture of membranes dangerous?

When preterm premature rupture of membranes occurs, it can have certain impacts on both the pregnant woman and the fetus. The risks of preterm premature rupture of membranes primarily include the possibility of umbilical cord prolapse, preterm birth, or infection during pregnancy. If the presenting part of the fetus has not descended and the umbilical cord slips into the vagina, umbilical cord prolapse can easily occur, which is very dangerous and can lead to fetal hypoxia or even stillbirth. After the rupture of membranes, bacteria originally present in the vagina may take this opportunity to enter the uterus, causing chorioamnionitis or endometritis. If the infection is not controlled in time, sepsis may also occur.

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Written by Zhao Li Li
Obstetrics
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Can I have a bowel movement if my membranes rupture early?

According to the current situation, if premature rupture of membranes has occurred, it is first necessary to clarify whether the amount of vaginal discharge is within the normal range. If a large amount of amniotic fluid flows out of the vagina after activity, try to minimize movement as much as possible. Generally, it is necessary to adopt a left lateral recumbent position with the buttocks elevated, to reduce the outflow of amniotic fluid. It is also necessary to timely use antibiotics to control infection, assess the current progress of labor and the condition of the fetus, and decide on the specific mode of delivery. Normally, bowel movements can be performed, but try to minimize the number of times getting out of bed to avoid the continuous outflow of amniotic fluid or the occurrence of umbilical cord prolapse.

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Written by Liu Wen Li
Obstetrics
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Does premature rupture of membranes require induction of labor?

The management of premature rupture of membranes varies depending on the gestational age. If the rupture occurs very early in pregnancy, the doctor will assess the maturity of the fetus. If it seems that the child still has a long way to mature, or it is difficult to conservatively maintain the pregnancy until maturity, induction of labor may be recommended. If the doctor feels that the fetus is mature enough, then induction of labor may be considered, which involves the administration of drugs to induce labor. If it is between these two scenarios, expectant management may be advised, which involves not inducing labor, along with infection prevention, bed rest, etc. Since infection can occur after a long duration of membrane rupture, it is important to closely monitor infection indicators during this period. If an infection is detected, labor may be induced using drugs to expedite delivery.