Is premature rupture of membranes prone to infection?

Written by Zhang Lu
Obstetrics
Updated on January 26, 2025
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After premature rupture of membranes, various aspects of impact on both the mother and the fetus can occur, but the most important is the risk of infection.

After the rupture of membranes, since the amniotic cavity is connected to the vagina through the cervix, the bacteria present in the vagina can potentially enter the amniotic cavity through the cervix and cause an infection inside the amniotic cavity. Therefore, after the rupture of membranes, the most crucial action is to prevent infection, primarily using antibiotics for treatment and closely monitoring indicators of infection.

Monitoring for infection after premature rupture of membranes can be done in the following ways: first, pay attention to the characteristics of the amniotic fluid, which often has an odor in case of infection; second, monitor infection indicators, including white blood cells and C-reactive protein; third, observe if the pregnant woman exhibits any symptoms of fever.

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

Premature rupture of membranes refers to the rupture of the amniotic sac before labor begins. The diagnosis of premature rupture of membranes is mainly based on clinical symptoms, gynecological examination, and ultrasound assessment. Ultrasound can only serve as an auxiliary tool for diagnosing premature rupture of membranes. This is because, during premature rupture, an ultrasound might sometimes show a reduction in amniotic fluid due to significant fluid leakage, although amniotic fluid can also regenerate quickly. In such cases, an ultrasound done for premature rupture of membranes might still show the amniotic fluid level within the normal range. Therefore, the diagnosis of premature rupture of membranes heavily relies on clinical symptoms and gynecological examination. The presence of a large amount of fluid leaking from the vagina and a change in color on the amniotic fluid test strip during a gynecological examination are crucial for confirming the diagnosis. Ultrasound, in this context, serves only as a supplementary diagnostic method.

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Written by Zhao Li Li
Obstetrics
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Premature rupture of membranes symptoms

Under normal circumstances, if there is no regular contraction and the amniotic fluid breaks after full-term, it is known as premature rupture of membranes. Regardless of the period, if premature rupture of membranes occurs, active symptomatic treatment is necessary. Normally, premature rupture of membranes may involve sudden vaginal discharge caused by various reasons. The amount of discharge can vary, usually being continuous, with the duration also varying. It starts with a large amount, then gradually decreases, with a few cases being intermittent. The vaginal discharge is usually related to changes in the pregnant woman's posture or activity. It can be seen that fluid leaks from the vaginal opening, or flows out from inside the vagina during upper fetal head push, pressing on the fundus, or when the posture of the pregnant woman changes. This condition can then be confirmed as premature rupture of membranes.

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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.

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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 Wang Jing Hua
Obstetrics and Gynecology
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How to prevent premature rupture of membranes?

The prevention of premature rupture of membranes primarily involves preventing infection. This is because the main cause of premature rupture of membranes is likely due to infection, though it can also be due to pelvic issues and irregular uterine contractions that stimulate the rupture. Therefore, those with a history of premature rupture of membranes should undergo relevant examinations early in pregnancy and receive prenatal care routinely, including tests for vaginal secretions. Even if one feels no discomfort, it is advisable to conduct an examination for vaginal pathogens and, if necessary, begin medication early. (Medication should be used under the guidance of a professional doctor.)