Reasons for premature rupture of membranes
Release time : 05/08/2025 09:30:02
Premature rupture of membranes is an important cause of premature birth and a major factor that greatly affects the health of mothers and babies. Once signs of premature rupture of membranes are discovered, they must be dealt with promptly.
What causes premature rupture of membranes? This article will discuss the causes, management, and risks of premature rupture of membranes.
Causes of premature rupture of membranes: Premature rupture of membranes can lead to an increased rate of preterm labor, an increase in perinatal mortality, and an increase in intrauterine infection and puerperal infection rates. Once premature rupture of membranes occurs, it is a dangerous phenomenon.
So what is the cause of premature rupture of membranes? Let's take a look together.
1. There are many causes for inadequate placental development, including not only factors related to the placenta itself but also early pregnancy vitamin C deficiency, copper deficiency, and smoking by pregnant women.
2. Infection leading to preterm rupture of membranes (PROM) can cause intrauterine infection, which has traditionally been considered a causal relationship between PROM and infection. However, in recent years, it has been widely recognized that infection is the most significant cause of PROM.
3. In non-pregnant states, the cervical os can dilate freely to an internal diameter of 8.0 without resistance, thus diagnosing cervical incompetence. The main manifestations of cervical incompetence are laxity of the os and deficiency in the isthmus.
4. Abnormal intrauterine pressure, with incongruent intrauterine pressure, is commonly observed in cases of cephalopelvic disproportion and fetal position abnormalities.
An excessive intrauterine pressure is commonly observed in twin pregnancies, polyhydramnios, severe coughing and difficulty with defecation.
5. Trauma and mechanical stimuli are primarily categorized into two types: medically induced and non-medically induced.
Non-medical causes, such as sexual activity in the late stages of pregnancy.
Medical interventions include multiple amniocenteses, repeated vaginal examinations, and evacuation of the membranes for induced labor.
Premature rupture of membranes refers to the rupture of membranes in the middle and late pregnancy or before labor, and amniotic fluid suddenly flows out of the vagina. Among pregnant women, the incidence rate of premature rupture of membranes is about 2.7-17%. It is a serious complication in the third trimester of pregnancy and a great threat to the lives of mothers and infants. Therefore, it must not be taken lightly.
The following are the major risks associated with premature rupture of membranes for both mother and baby: 1. * Premature Birth**: Premature rupture of membranes can lead to an early birth of the baby, increasing the risk of infection. 2. * Increased Infection Risk**: Due to the rupture of the amnion, the baby is more likely to come into contact with bacteria or viruses from the outside, thereby increasing the risk of infection. 3. * Reduced Amniotic Fluid**: Rupture of the amnion can lead to a reduction in amniotic fluid, affecting the normal development of the fetus. 4. * Placental Dysfunction**: Premature rupture of membranes may affect the function of the placenta, leading to insufficient oxygen supply for the fetus. 5. * Bleeding Risk**: After the rupture of the membranes, the baby may not be able to expel it in time, resulting in maternal bleeding, posing a threat to maternal and infant safety. To prevent premature rupture of membranes, expectant mothers should regularly undergo prenatal check-ups, pay attention to changes in fetal movement, and seek medical attention if there are any abnormalities promptly. Additionally, maintaining good lifestyle habits and avoiding excessive fatigue can help reduce the risk of premature birth.
1. For the mother, the most severe consequence of premature rupture of membranes is infection, characterized by fever, elevated white blood cell count, uterine tenderness, accelerated fetal heart rate, and foul-smelling amniotic fluid. The pathogens originate from the vagina or external genitalia, often accompanied by bacteremia.
2. For fetuses that are not mature, premature rupture of membranes poses the greatest threat of prematurity.
For mature fetuses, premature rupture of membranes poses a threat due to the resultant oligohydramnios, leading to fetal distress in utero. Moreover, it can increase the risk of postnatal sepsis, pneumonia, and respiratory distress syndrome. Consequently, there is a significantly increased mortality rate among the perinatal infants.
3. The premature rupture of membranes is a signal for dystocia, which is also quite important.
Due to factors such as dystocia, such as disproportion between the pelvis and the fetus (dyscephalic presentation), or high-lying fetal head (transverse lie), premature rupture of membranes (PROM) is more likely to occur.
Premature rupture of membranes (PROM) is associated with a decrease in amniotic fluid volume, infection, and intrauterine distress, leading to an increased rate of dystocia and cesarean section. This indicates that PROM is closely linked to dystocia; numerous cases of dystocia are inseparable from this factor.
The dangers of premature rupture of membranes are significant. If expectant mothers notice any signs of premature rupture of membranes, it is imperative to seek medical attention and take appropriate measures promptly.
What are the symptoms of premature rupture of membranes? Since premature rupture of membranes carries such serious risks, we must be vigilant in detecting it in time and take prompt measures to treat it.
Preterm rupture of membranes is associated with certain symptoms. Pregnant women should be aware of these symptoms and seek medical examination early if they experience similar symptoms.
Let's take a look at the symptoms of premature rupture of membranes.
1. Signs of premature rupture of membranes: The main symptom of premature rupture of membranes is whether or not it occurs, with various reasons leading to sudden vaginal discharge, and the volume of the discharge can vary from minimal to significant.
The vaginal discharge from premature rupture of membranes usually persists in varying durations, initially being copious before gradually decreasing. In some cases, it may be intermittent.
Vaginal discharge is generally related to changes in maternal position and activity during pregnancy. If a pregnant woman experiences sudden vaginal discharge after vigorous exercise, it may indicate the possibility of premature rupture of membranes (PROM).
2. The physical signs of premature rupture of membranes in pregnant women may include the presence of fluid at the vaginal opening, as well as no fluid being present.
If no fluid flows out, fluid may flow out from the vaginal opening during anal examination, push the fetal head up, press the fundus of the uterus, or change the pregnant woman's position. Liquid may not flow out after these auxiliary operations.
The fluid that is discharged is usually thin and may contain meconium or amniotic fluid.
The pregnant woman with an emergency hospitalization may bring underwear, sanitary napkins or tissues to the hospital, and the doctors will also carefully examine them.
How is premature rupture of membranes diagnosed? If a woman suspects that she has premature rupture of membranes, what tests does the doctor typically require to specifically diagnose it? 1. Presence of vaginal discharge: The pH value can be measured using a test strip. If the pH value is greater than or equal to 7, it indicates that the membranes have ruptured; since the pH value in the vagina is between 4.5 and 5.5, while amniotic fluid is between 7 and 7.5.
2. After drying, a vaginal smear slide is examined under the microscope. The presence of needle-like crystals is detected. A 0.5‰ mercurochrome stain reveals faint blue or unstained fetal epithelium and cilia.
Premature rupture of membranes can be diagnosed by staining with 0.1 - 0.5% Nile blue sulfate and finding orange fetal epithelial cells.
If indigo rouge is injected through abdominal amniocentesis, if it flows out from the vagina, the diagnosis can be confirmed.
The treatment measures for preterm rupture of membranes include: 1. * * Observation and rest**: The pregnant woman should rest in bed as much as possible, avoid activities, and reduce the risk of premature birth under the guidance of a doctor. 2. * Maintain cleanliness**: Pay attention to the hygiene of the vulva to prevent infection. 3. * Prevent infection**: Avoid sexual intercourse and the use of vaginal medicines to prevent infection from worsening. 4. * * Monitor fetal heart rate**: Regularly check the fetal heartbeat to ensure the safety of the fetus. 5. * Medication**: If infection or cord prolapse occurs, antibiotics or other medications may be necessary for treatment. 6. * Emergency management**: If severe complications such as cord prolapse occur, immediate medical attention is needed. 7. * Psychological support**: Faced with preterm rupture of membranes, pregnant women may feel anxious and uneasy. The support and understanding of family members are very important. Preterm rupture of membranes is an emergency situation that requires timely diagnosis and treatment by a doctor. The above are some basic treatment measures, but specific actions should be based on individual circumstances and the advice of a doctor.
Generally, after rupture of membranes, labor usually occurs within 24 hours. There is no need to prevent labor progression regardless of the gestational age, and thus, it is appropriate for doctors to handle this situation by the following measures: 1. For pregnant women with a high presenting part, after the membranes rupture, they should rest in bed with their legs elevated, tilting their head downward and their feet higher than their head, to prevent cord prolapse, especially in cephalic presentation and twin pregnancies.
2. Maintain vulvar cleanliness, and for those who have broken membranes more than 12 hours, antibiotics should be given to prevent infection.
3. At 36 weeks of gestation, if the labor has not commenced within 24 hours, the incidence and mortality rates of amniotic fluid and placental infection, as well as perinatal complications, will increase accordingly. To minimize infection risks and prevent maternal and fetal complications, active induction of labor should be actively pursued.
If the pregnancy reaches 36 weeks, is not in labor, and the fetus is not mature, but the pregnant woman insists on maintaining the pregnancy, under the premise of active monitoring and preventing infection, absolute bed rest can be given, uterine contraction inhibitors can be administered, and the pregnancy should continue, striving for opportunities to promote fetal lung maturity and cervical ripening. This is conducive to the prognosis of the perinatal infant.
If clinical signs of mastitis occur, such as accelerated fetal heart rate (FHR) in the mother, reaching up to 160 bpm, uterine tenderness, contractions, foul-smelling amniotic fluid, and vaginal discharge with purulent characteristics, accompanied by leukocyte counts above 15×10^9/L and C-reactive protein levels of 2 mg/dl, immediate induction of labor or, if necessary, cesarean section should be performed.
For those with breech presentation, cephalopelvic disproportion, pelvic contraction, or other obstetric complications, the doctor will make corresponding managements according to the situation.
For preterm rupture of membranes, expectant management or termination of pregnancy can be considered based on the situation.
At full term, premature rupture of membranes requires the selection of a method for termination of pregnancy, either by induction or by cesarean section.
Regardless of the situation, prophylactic antibiotics should be administered if rupture occurs more than 12 hours.
The medical content mentioned in this text is for reference only.
If you feel unwell, it is recommended to seek medical attention immediately, and the medical diagnosis and treatment will be subject to offline diagnosis.