Leakage of amniotic fluid before 37 weeks of gestation is defined as PPROM. It usually occurs between 24-32 weeks of pregnancy. The most common cause of PPROM is infection of the uterus. There is also an increased risk of PPROM if:
- Smoking Pregnants
- Insufficient Weight Gain During Pregnancy
- Having Early Watering İn Previous Pregnancies
- Short Cervix
- Excess Amniotic Fluid
In a pregnant woman whose amniotic fluid comes early, there is a risk of infection because the amniotic membrane between the sterile environment in which the baby is located and the vaginal cavity, which carries a large number of bacteria, opens. The longer the time elapses since the amniotic fluid comes out, the higher the risk of developing an infection. The infection can be severe enough to be life-threatening for the mother and baby.
How do I know when I have a PPROM?
The leakage of amniotic fluid manifests itself with a wetness in the vulva and inner parts of the legs. It is a colorless and odorless liquid. Some pregnant women may confuse vaginal discharge or urinary incontinence when going to the toilet. However, the wetness felt in these cases is very mild and does not continue. If you still feel wetness on your pad, you’d better contact your doctor.
Is it detectable in the examination?
Yes. When your doctor does an examination, he or she sees the leakage of amniotic fluid from the cervix. In addition, it can be noticed that the baby’s fluid has decreased on ultrasound. If there is a suspicious leak, your doctor may want to clarify whether your water is coming out with various tests such as amnisure or actimprom.
What if I had a PPROM?
The biggest problem in a pregnant woman who have PPROM is the development of infection. Infection manifests itself with high fever, foul-smelling discharge, pain in the groin, and an increase in leukocytes in the blood. If there are signs of infection (high fever, increased leukocytes in the blood, foul-smelling discharge), it is necessary to make a decision to initiate the labor.
If there is no sign of infection despite the diagnosis of PPROM, then we can wait up to 34 weeks. During this waiting period, we give prophylactic antibiotics to our patient and we monitor them with ultrasound at regular intervals.
After the 34th week is completed, we do not prefer to wait more, we induce her delivery.
If the PPROM occur in very early weeks, in this case, we can decide to terminate the pregnancy because the possibility of adverse fetal outcome increases too much.
If PPROM occur before the 24th week, your doctors will offer you the option to terminate the pregnancy, as the fetal outcome worsened.
Can the amniotic membrane repair itself after rupture?
Yes. Rarely, the amniotic membrane may reclose spontaneously after rupturing.
What precautions can I take against PPROM?
Perhaps the most important measure is to quit smoking and eat adequately during pregnancy. In addition, in doubtful cases, you should communicate with your doctor without delay.
I wish you healthy days.
Prof. Dr. Yavuz Şimşek