Does premature rupture of membranes require induction of labor?

Written by Liu Wen Li
Obstetrics
Updated on November 10, 2024
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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 Zhang Lu
Obstetrics
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Can premature rupture of membranes be detected?

Premature rupture of membranes refers to the rupture of membranes before labor, manifested as vaginal discharge and abdominal pain, among other symptoms. The diagnosis of premature rupture of membranes is primarily conducted through the following methods: First, based on the patient's symptoms. The most typical symptom of premature rupture of membranes is the discharge of clear fluid from the vagina. This can generally be identified as amniotic fluid by the naked eye, which helps in diagnosing premature rupture of membranes. Second, if the amount of vaginal discharge is minimal, PH test strips can be used for detection. A change in the PH strip may indicate a diagnosis of premature rupture of membranes. Third, an ultrasound can also generally assess premature rupture of membranes, as the amount of amniotic fluid will decrease when the membranes have ruptured. These methods combined can confirm the presence of premature rupture of membranes.

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Written by Zhang Lu
Obstetrics
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Will the fetus still move if the membranes rupture prematurely?

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 Yue Hua
Obstetrics and Gynecology
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Premature rupture of membranes requires what examinations?

To diagnose premature rupture of membranes, first, a pH test of the vaginal fluid must be conducted. The normal pH value of vaginal fluid in women ranges from 4.5 to 5.5, whereas the pH of amniotic fluid ranges from 7.0 to 7.5. If the membranes have ruptured prematurely, the pH value would be greater than 6.5. Additionally, a smear test of the vaginal fluid can be done by placing vaginal secretions under a glass slide and examining them under a microscope. If fern-like crystals are observed, this indicates the presence of amniotic fluid. Furthermore, an ultrasound examination can be conducted. If the ultrasound shows a rapid decrease in the amount of amniotic fluid, this can assist in the diagnosis.

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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 Zhang Lu
Obstetrics
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Symptoms of premature rupture of membranes infection

Premature rupture of membranes refers to the breaking of the fetal membrane before the onset of labor, followed by the leakage of amniotic fluid. The greatest risk of premature rupture of membranes is the potential to cause an infection in the amniotic cavity. The symptoms of infection due to premature rupture of membranes include the following aspects: First, the smell and color of the amniotic fluid will change. The amniotic fluid may become purulent and have a foul smell, which suggests an infection within the amniotic cavity. Second, blood tests can reveal elevated infection markers, primarily an increase in white blood cells and C-reactive protein well above the normal range. Third, the patient may experience contractions or lower abdominal tenderness and rebound pain. When there is an infection in the amniotic cavity, symptoms of peritonitis may occur, along with manifestations of contractions, presenting as episodic pain in the lower abdomen. These are the symptoms of infection from premature rupture of membranes.