Causes of preterm premature rupture of membranes

Possible contributors include infection or inflammation around the membranes, bleeding during pregnancy, pressure from excess amniotic fluid or a multiple pregnancy, and prior cervical or uterine procedures. A previous early membrane rupture or spontaneous preterm birth may also shape an individual risk assessment.

The amniotic sac surrounds the baby and holds the waters. PPROM means that this sac has opened before labour begins and before the pregnancy reaches term. Fluid may come as a gush or a persistent trickle, and it can be mistaken for urine or vaginal discharge.

Once the membranes open, clinicians consider gestational age, signs of labour, the baby's wellbeing and whether infection is developing. The cause cannot be confirmed simply from the amount or colour of fluid.

Contact your maternity unit promptly and describe when the leaking began, its colour and smell, and whether you have pain, bleeding, fever or contractions. Use a clean sanitary pad to observe the fluid; do not insert a tampon or have sex while waiting for assessment.

Assessment may include checking your temperature and pulse, listening to the baby's heartbeat, examining the fluid and looking for labour or infection. Management depends on the pregnancy and findings; it can include monitoring, medicines that support the baby's preparation for early birth, or planning birth when continuing the pregnancy is less safe.

Seek urgent maternity assessment for any suspected gush or ongoing watery leakage before term. Go immediately if the fluid is green, brown, blood-stained or foul-smelling, or if you have fever, chills, abdominal tenderness, regular contractions, heavy bleeding, reduced fetal movement, or something appears in the vagina.

Ask how the diagnosis will be confirmed, how you and the baby will be monitored, which signs should trigger an immediate return, and how gestational age affects the plan. You can also ask why an antenatal steroid injection or induction of labour might be considered in your circumstances.