“Waters have Released”

Rupture of the membranes (ROM)

AKA “Waters have released” or “leakage of clear fluid from the vagina”
– Represent the spontaneous rupture of fetal membranes before the onset of labor, despite of gestational age.

The Amniotic Sac

Is a thin membrane which surrounds the baby and contains the water in which your baby is during pregnancy. This membrane eventually will break, either at home, during labor or artificially.

Premature Rupture of Membranes (PROM)

Can occur either time prior to the onset of labor at:

1. Term

37 completed weeks of gestation and up until 42 completed weeks of gestation.

Known as Premature Rupture of the Membranes (PROM)
– If you are in labor, you feel pressure of the baby in your pelvis or the urge to push call 911 or go to the hospital or birth center or call your midwife if you planned a home birth.
– If you are not in labor, delivery of the baby can take up to 24 hours, since after this is the time of greater risk of chorioamnionitis.
>> Usually a 12-hour scope is given for you to enter in spontaneous labor before oxytocin (pitocin) induction is started.
Other methods of inducing labor during this time may be used.

2. Preterm

(before 37 weeks):
Preterm Premature Rupture of the Membranes (PPROM)
If you are early in your pregnancy there is a greater risk of infection. Before 37 weeks of gestation you MUST go straight to the hospital to increase chances of survival for your baby.

Related “How Do You Know and What To Do When Water Breaks”

What could cause your water to break before labor?

Cause: unknown but hypothesized:

  • Vaginal and cervical infections (most common: bacterial vaginosis, trichomonas, Group B Streptococcus)
  • Incompetent cervix
  • Nutritional deficiencies
  • Polyhydramnios
  • Fetal malpresentation
  • Multiple gestation or a large baby
  • Occupational fatigue
  • Vaginal exams, if the woman is not in labor, it is more likely to stimulate labor, and/or introduce infection.
  • Sweeping of the membranes

Related Membrane/cervical stripping or sweeping the membranes

Risks once membranes are ruptured

1. Preterm labor, labor is likely to begin soon if the pregnancy is at or near term.
2. Umbilical cord prolapse
3. Umbilical cord compression
secondary to prolapsed umbilical cord or oligohydramnios
4. Chorioamnionitis may happen if delivery is delayed more than 24 hours after PROM.
5. Pulmonary hypoplasia this is a concern and poor prognosis if there is PROM before 24 weeks resulting from oligohydramnios which leads to poor fetal lung development
6. Placental abruption
7. Neonatal infection
8. Stillbirth/neonatal death

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