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Various mothers experience pregnancies differently. While some give birth vaginally only after the 40th week of pregnancy or full-term pregnancy, others may face premature labour or emergencies, like their water might be broken before the contractions start. When an expectant woman’s water breaks before the 37th week of pregnancy, and labour doesn’t start immediately after, it is called Premature Rupture of Membranes. The risk of infection soars within a few hours of PROM. This article aims to underline the PROM infection risk while delineating the underlying reasons for PROM.
What Does It Feel Like When the Water Breaks?
The uterus is not the only layer protecting the baby. A fluid-filled membranous sac called the amniotic sac shields the baby from harm’s way. When a pregnant lady’s water breaks, it means that the amniotic sac can no longer protect the baby from bacterial and viral infections.
When an expectant mother’s water breaks, she might have a mild popping sensation followed by wetness in the vagina or perineum area. Clear or pale yellow watery fluid might leak through the cervix and trickle or gush out from the vagina. Unlike urination, this flow cannot be controlled.
What Follows When Water Breaks Prematurely?
How long after water breaks does infection start? The expectant mother must be rushed to the hospital at the earliest. If the labour doesn’t start within 12 to 24 hours of the PROM, the risk of uterine infections and other complications rises.
At the hospital, symptoms of infection, such as foul-smelling vaginal discharge, abdominal pain in the mother, and foetal tachycardia or fast heart rate in the baby, are closely monitored. The mother’s temperature, blood pressure, and pulse are recorded regularly.
If the mother is at least 34 weeks pregnant and there are no signs of infection or foetal health issues, doctors might allow the pregnancy to reach its full term.
When the woman is between 24 and 34 weeks of pregnancy, and the water breaks without any sign of labour, doctors might prescribe antibiotics to prevent infection, and inject potent steroids to speed up the baby’s lung maturity in an attempt to delay the delivery until the baby is fully grown.
If the pregnancy has only reached the 32nd week and the delivery is to take place soon, doctors might prescribe magnesium sulfate medication to protect the fetus against cerebral palsy. Intravenous antibiotics are promptly administered to reduce the risk of infection after water breaks without labour, such as group B strep (GBS) infection in the newborn.
What Causes a Delay in Labour After Water Breaks?
Soon-to-be mothers usually feel the labour pangs very shortly after their water breaks. A delay in uterine contractions after Premature Rupture of Membranes could be caused by the following:
- First-time mothers usually experience long, drawn-out labour for around 12 to 18 hours. The rupture of membranes could be an early stage of labour; the contractions might begin quite late.
- The contractions might have already begun, but are too mild to notice. The frequency and intensity of the contractions increase gradually.
What Causes Premature Rupture of Membranes?
The general health, way of living, and medical history of pregnant women might heighten the risk of Premature Rupture of Membranes. The following is a list of causes:
- Having a history of Premature Rupture of Membranes in a previous pregnancy
- Experiencing vaginal bleeding after 12 weeks of pregnancy
- Being diagnosed with short cervical length
- Suffering from Intra-amniotic Infection (IAI) or bacterial infection in the placenta, amniotic fluid, and foetal membranes
- Placental insufficiency
- Having an excess of amniotic fluid or Polyhydramnios
- Being diagnosed with a hematoma, where blood collects between the uterine wall and the gestational sac or placenta.
- Regular smoking or indulging in recreational drugs while pregnant
- Having a congenital uterine abnormality or a differently shaped womb
- Being underweight and malnourished
- Suffering from Ehlers-Danlos syndrome, a connective tissue disorder
- Being pregnant with twins or more babies
Risks of Premature Rupture of Membranes
Ensuring safe delivery always remains the priority of gynaecologists. While the risk of infection after water breaks is considered low in the first 24 hours, infections such as chorioamnionitis and sepsis might develop as time passes. The following complications are likely to crop up:
Cord Prolapse
A rare situation where the umbilical cord falls through the mother’s cervix into the vagina. This can be life-threatening for the baby.
Pulmonary Hypoplasia
In case an expectant mother’s water breaks when the gestation age is less than 24 weeks, the baby’s lungs fail to develop normally because of a lack of fluid around them. The mortality rate is high in this situation, while survivors face chronic bronchitis, pneumonia, etc.
Placental Abruption
This is when the placenta detaches from the inner wall of the uterus before the delivery, causing heavy bleeding. This can be fatal for both the mother and the baby.
Conclusion
In the situation of water breaking without contractions, the infection risk is inevitably high. Without an amniotic sac, the foetus loses the chief layer of protection as the fluid flows out. PROM makes delivery a more complicated and time-sensitive procedure. Expert medical attention is the primary requirement in such cases.