PPROM: what it means and what happens next

PPROM stands for preterm prelabour rupture of membranes. Fluid may come as a gush or a continuing trickle that cannot be controlled like urine. Once the membranes open, labour may begin, infection can develop, and the amount of fluid around the baby may fall. The implications depend strongly on gestational age and the health of both parent and baby.

Assessment may include a sterile speculum examination, checks of temperature and pulse, monitoring of the baby's heart rate, and tests for infection. Repeated digital vaginal examinations are generally avoided unless labour is active because they can introduce infection.

Put on a clean sanitary pad, note the fluid's colour, smell, and when it started, then contact maternity triage without delay. Do not insert a tampon, have penetrative sex, or place anything in the vagina while awaiting advice. Depending on timing and findings, care may include hospital observation, antibiotics, antenatal corticosteroids to support fetal lung preparation, or delivery when continuing the pregnancy is less safe.

Seek urgent maternity assessment for any suspected water breaking before term, even without pain. Call immediately if fluid is green, brown, bloody, or foul-smelling; if you develop fever, chills, abdominal tenderness, contractions, or feel unwell; or if fetal movement decreases. Call emergency services if you can feel or see the umbilical cord, have heavy bleeding, or are collapsing.

Ask how PPROM was confirmed, whether there are signs of infection or labour, and how the baby's wellbeing will be monitored. Clarify whether you need antibiotics or steroid injections, what would trigger induction or caesarean birth, and which symptoms should bring you back after discharge.