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 Yue Hua
Obstetrics and Gynecology
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The hazards of premature rupture of membranes

Premature rupture of membranes primarily affects the mother by leading to infections. Once the membranes rupture, bacteria can easily enter the uterine cavity from the vagina, causing chorioamnionitis. Additionally, it may lead to placental abruption, as the rupture of the membranes causes a decrease in abdominal tension, thus making placental abruption more likely to occur. It also leads to an increased rate of cesarean sections, because the reduction in amniotic fluid can cause irregular uterine contractions and the umbilical cord to be easily compressed, which may endanger the fetus. The main impact on the fetus is an increased risk of preterm birth.

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Written by Zhang Lu
Obstetrics
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How is premature rupture of membranes diagnosed?

Premature rupture of membranes refers to the rupture of the membranes before the onset of labor, followed by the leakage of amniotic fluid. It is necessary to distinguish premature rupture of membranes from increased vaginal discharge and urinary incontinence. The methods to diagnose premature rupture of membranes include the following aspects: First, symptomatically, after the rupture of membranes, a clear liquid intermittently leaks from the vagina, accompanied by mild abdominal pain or bloody show. Second, after the rupture of membranes, the liquid leaking from the vagina can be tested with pH paper, which in most cases will change color, confirming the diagnosis of premature rupture of membranes. Third, an ultrasound can be used to observe a reduction in the amount of amniotic fluid within the amniotic cavity. Fourth, the leaking fluid can be examined under a microscope to observe "fern-like" crystallization, which can also confirm the diagnosis of premature rupture of membranes.

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Written by Zhao Li Li
Obstetrics
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What will happen to fetal movement if the membranes rupture prematurely?

Generally, if premature rupture of membranes occurs, it is necessary to clearly determine the specific development of the embryo and the specific gestational age. If the fetus is preterm with premature rupture of membranes, it is necessary to promptly provide anti-infection treatment and promote fetal lung maturity among other symptomatic treatments. If the fetus is already at term, it is important to closely monitor the specific condition of cervical dilation and abdominal pain to decide on the mode of delivery. Normally, premature rupture of membranes does not affect fetal movement at all. A fetal heart rate monitoring test can be conducted to clarify the specific situation of the embryo's development within the uterine cavity and whether there is any fetal hypoxia, to comprehensively analyze the situation.

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Written by Zhang Lu
Obstetrics
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Premature rupture of membranes symptoms

Premature rupture of membranes refers to the rupture of the membranes before labor, and the symptoms of premature rupture of membranes include the following aspects: Firstly, a large amount of fluid will flow out of the vagina. Once the membranes rupture, amniotic fluid will flow out intermittently, releasing a colorless and odorless fluid, which will wet the underwear. Secondly, there may be a small amount of bleeding. When the membranes rupture, the capillaries at the edges of the membranes may bleed slightly, mixing with the amniotic fluid, resulting in some spotting or slight bleeding. Thirdly, there may be abdominal pain and the sensation of contractions. After the rupture of the membranes, this can stimulate the cervix, causing the release of inflammatory mediators from the cervix and inducing uterine contractions, leading to contractions and the sensation of abdominal pain. These are the symptoms of premature rupture of membranes.

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Written by Zhang Lu
Obstetrics
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Will the fetus still move if the membranes rupture prematurely?

Premature rupture of membranes refers to the rupture of membranes before labor, with amniotic fluid leaking intermittently. Based on the timing of the rupture, it can be classified into term premature rupture of membranes and preterm premature rupture of membranes. Although amniotic fluid will leak after the membranes rupture, leading to a reduction in its volume, amniotic fluid continues to be produced. Therefore, the fetus will still continue to move actively inside the uterus. In most cases, there is no abnormality in fetal movements after membrane rupture. However, if the membranes have been ruptured for a long time, or if the fetus experiences intrauterine hypoxia due to other factors, a decrease or absence of fetal movements may occur. Thus, normally, fetal movements continue after membrane rupture, but they may decrease or disappear if hypoxia occurs.