PPROM and placental abruption: what to know

PPROM is a rupture of the membranes before labour. Placental abruption is when the placenta separates from the womb wall before birth. Abruption may cause vaginal bleeding, persistent abdominal or back pain, a hard or tender womb, contractions or changes in the baby’s heart pattern. Bleeding can sometimes be concealed, so the absence of visible blood does not rule it out. The conditions can overlap, and only urgent clinical assessment can clarify what is happening.

Call emergency maternity services immediately for suspected PPROM with pain, bleeding, contractions or a sudden change in fetal movement. Lie on your side while waiting if that is comfortable, avoid food or drink if emergency staff advise it, and do not put anything into the vagina. Use a pad rather than a tampon and tell the team when leakage, pain or bleeding began. Hospital care may include maternal observations, fetal monitoring, blood tests and a discussion of birth, including [Caesarean Section](/treatments/pregnancy-and-birth-care/caesarean-section/).

Seek emergency help for heavy or increasing bleeding, severe or constant abdominal pain, faintness, weakness, a rigid or very tender abdomen, regular contractions, or reduced fetal movement. Treat these as urgent even if the fluid leak is small or bleeding is not obvious.

Could bleeding be concealed? How are placental separation and fetal wellbeing being assessed? What findings would require immediate birth? Will I need blood tests or specialist neonatal support?