PPROM at 20 weeks: what to know

Some people notice a gush; others notice repeated dampness. Urine and discharge can have a similar appearance, so the source needs professional assessment. A clinician may ask about the leak, check your observations, examine you, and arrange an ultrasound. The team will consider whether there are signs of infection or labour and how much fluid is present. At this gestation, counselling should be individual and compassionate, with time to discuss what each possible pathway means.

Call your maternity unit immediately and follow its instruction about attending hospital. Wear a clean pad, note the fluid's colour and smell, and avoid intercourse, tampons, swimming, and vaginal products until you have been examined. Do not self-start antibiotics or other medicines. Your doctors may discuss observation, repeat assessments, treatment for infection when indicated, and what happens if labour or serious infection occurs. Steroid injections are considered at a later point in pregnancy in selected situations, so ask when they could be relevant.

Seek emergency help for a fever, chills, increasing pain, regular contractions, vaginal bleeding, foul-smelling or green fluid, dizziness, fainting, or feeling acutely unwell. These symptoms require immediate review because infection, bleeding, or labour may need treatment. A leak without these symptoms still warrants prompt contact.

Ask how the diagnosis was established, what monitoring you need, what activities are safe, and which changes mean you should return. Ask how decisions will be reviewed, who is available outside office hours, and what counselling or practical support can help you cope.