Can an ultrasound detect premature rupture of membranes?

Written by Zhang Lu
Obstetrics
Updated on September 16, 2024
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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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Written by Yue Hua
Obstetrics and Gynecology
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The hazards of premature rupture of membranes

Premature rupture of membranes primarily affects the mother by leading to infections. Once the membranes rupture, bacteria can easily enter the uterine cavity from the vagina, causing chorioamnionitis. Additionally, it may lead to placental abruption, as the rupture of the membranes causes a decrease in abdominal tension, thus making placental abruption more likely to occur. It also leads to an increased rate of cesarean sections, because the reduction in amniotic fluid can cause irregular uterine contractions and the umbilical cord to be easily compressed, which may endanger the fetus. The main impact on the fetus is an increased risk of preterm birth.

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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.)

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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.

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Written by Du Rui Xia
Obstetrics
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Is premature rupture of membranes dangerous?

When preterm premature rupture of membranes occurs, it can have certain impacts on both the pregnant woman and the fetus. The risks of preterm premature rupture of membranes primarily include the possibility of umbilical cord prolapse, preterm birth, or infection during pregnancy. If the presenting part of the fetus has not descended and the umbilical cord slips into the vagina, umbilical cord prolapse can easily occur, which is very dangerous and can lead to fetal hypoxia or even stillbirth. After the rupture of membranes, bacteria originally present in the vagina may take this opportunity to enter the uterus, causing chorioamnionitis or endometritis. If the infection is not controlled in time, sepsis may also occur.

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Written by Zhao Li Li
Obstetrics
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What will happen to fetal movement if the membranes rupture prematurely?

Generally, if premature rupture of membranes occurs, it is necessary to clearly determine the specific development of the embryo and the specific gestational age. If the fetus is preterm with premature rupture of membranes, it is necessary to promptly provide anti-infection treatment and promote fetal lung maturity among other symptomatic treatments. If the fetus is already at term, it is important to closely monitor the specific condition of cervical dilation and abdominal pain to decide on the mode of delivery. Normally, premature rupture of membranes does not affect fetal movement at all. A fetal heart rate monitoring test can be conducted to clarify the specific situation of the embryo's development within the uterine cavity and whether there is any fetal hypoxia, to comprehensively analyze the situation.