Will the fetus still move if the membranes rupture prematurely?

Written by Zhang Lu
Obstetrics
Updated on October 25, 2024
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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.

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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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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 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 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.

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Written by Du Rui Xia
Obstetrics
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How long can premature rupture of membranes last?

When premature rupture of membranes occurs, it can last up to 24 hours. If labor has not commenced 24 hours after rupture, pregnancy termination becomes necessary, and one can either induce labor to facilitate a vaginal delivery or opt for a cesarean section. For ruptures occurring between the 28th and 35th weeks of pregnancy, as the baby's lungs are not yet fully developed, it is crucial to administer medication promptly to help mature the fetal lungs and extend the gestational period as much as possible. Once the fetal lung development is adequate, pregnancy should be terminated in a timely manner. For cases of premature rupture of membranes occurring after 36 weeks of pregnancy, where fetal development is generally mature, pregnancy can be terminated more promptly.