What are the risks of premature rupture of membranes?

Written by Yue Hua
Obstetrics and Gynecology
Updated on September 07, 2024
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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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Written by Zhang Lu
Obstetrics
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Is premature rupture of membranes prone to infection?

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 Yue Hua
Obstetrics and Gynecology
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Can premature rupture of membranes recover?

Premature rupture of membranes cannot be reversed. This means that the patient's membranes rupture before labor begins, and the ruptured membranes cannot be restored to their original, unruptured state. When the membranes rupture, most patients will feel fluid leaking from the vagina, and the patient does not experience abdominal pain or any sensation of being about to give birth; this is referred to as premature rupture of membranes. Upon discovering this condition, the first step is to have the patient rest in bed, as this situation can easily lead to the exposure of the fetal umbilical cord, which can endanger the child's life.

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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 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 Du Rui Xia
Obstetrics
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What should I do if the membranes rupture prematurely?

If it occurs before the baby is full-term and there is premature rupture of membranes, efforts should be made to preserve the pregnancy and prolong its duration. It is necessary to rest in bed, maintain cleanliness of the external genitalia, and closely monitor the condition of vaginal discharge, contractions, and whether the mother has any infections. If more than 12 hours have passed since the rupture of membranes, antibiotics should be administered to prevent infection, which can help prevent neonatal pneumonia and also reduce the occurrence of intracranial hemorrhage in the baby, as well as decrease the incidence of chorioamnionitis and postpartum endometritis. Medications that inhibit uterine contractions should be used if contractions occur. Additionally, medications that promote the maturation of the fetal lungs should be used to prevent preterm birth, which can lead to breathing difficulties.

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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.