Premature rupture of membranes complications

Written by Su Wen
Obstetrics and Gynecology
Updated on December 24, 2024
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The complications of premature rupture of membranes mainly include two aspects. The first is the impact on adults, that is, on the mother. It can lead to chorioamnionitis, causing severe infection, sepsis, and an increased chance of cesarean delivery. The second is the impact on the fetus. If premature rupture of membranes occurs, it may lead to fetal distress in utero, fetal death in utero, and neonatal infection. For instance, pneumonia caused by inhalation, neonatal asphyxia, and severe cases leading to death, etc. Once the symptoms of premature rupture of membranes are detected, it is necessary to be hospitalized as soon as possible to take the necessary treatment measures.

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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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What are the risks of premature rupture of membranes?

After premature rupture of membranes, the amniotic cavity is directly connected to the woman's vagina at this time, which primarily poses the risk of infection. If the fetus becomes infected, it is easy to lead to sepsis after birth, resulting in an increased mortality rate for the fetus. Additionally, it can cause bleeding in the fetus. Moreover, for the mother, there is a likely risk of placental abruption, which is due to the reduced abdominal tension after membrane rupture, making placental abruption more likely to occur. Furthermore, the mother is also prone to infections, which can easily lead to chorioamnionitis under these circumstances.

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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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Can an ultrasound detect premature rupture of membranes?

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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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.