Symptoms of premature rupture of membranes
Release time : 05/08/2025 09:30:02
Premature rupture of membranes refers to the natural rupture of membranes before labor.
Premature rupture of membranes with a gestational age of less than 37 weeks is also known as preterm labor (preterm).
Early rupture of membranes is the most common complication in the perinatal period, which can cause serious adverse outcomes for both pregnant women, fetuses, and newborns.
Premature rupture of membranes can lead to an increased risk of premature birth, an increase in perinatal mortality, and a rise in both intrauterine infection and postpartum infection rates.
This article mainly introduces the symptoms, causes, and treatment of ruptured membranes in pregnant women.
Signs of premature rupture of membranes: There are certain symptoms associated with premature rupture of membranes. Pregnant women should be aware of these symptoms in advance, and if they notice any similar symptoms early on, they should seek medical attention for examination promptly.
Let's take a look at the symptoms of premature rupture of membranes.
1. Symptoms of premature rupture of membranes: The primary symptoms are the sudden and unexpected vaginal discharge, which can vary in amount.
Vaginal discharge from premature rupture of membranes usually persists, with duration varying; it begins in large volume and gradually decreases, though some may exhibit intermittent discharge.
Vaginal discharge is often associated with changes in body position and activity during pregnancy. If a pregnant woman experiences sudden vaginal discharge after vigorous exercise, she should consider the possibility of premature rupture of membranes.
2. Labor membrane rupture signs: In pregnant women in a supine position, they may observe liquid seeping from the vagina or may not have any fluid seeping at all.
If no fluid flows out, fluid may flow out from the vaginal opening when the posterior vaginal fornix is lifted up, the fetal head is pushed up, the fundus of the uterus is pressed, or the pregnant woman changes her position during anal examination. No fluid may flow out after these auxiliary operations.
The fluid that is discharged is usually thin and may contain meconium or amniotic fluid.
Pregnant women requiring emergency hospitalization may bring underwear, sanitary napkins or toilet paper to the hospital. The doctors will also carefully examine these items.
The causes of premature rupture of membranes can lead to an increased rate of preterm birth, an increased mortality rate in the perinatal period, and both an increased rate of intrauterine infection and postpartum infection. Once it 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 reasons for dysplasia of membranes. In addition to the factors of membranes itself, factors such as vitamin C deficiency, copper deficiency and smoking in pregnant women in the first trimester are related to dysplasia of membranes.
2. Infected premature rupture of membranes leads to intrauterine infection. This is the traditional causal relationship between premature rupture of membranes and infection. In recent years, it has been generally recognized that infection and premature rupture of membranes are causal relationships, and infection is the most important cause of premature rupture of membranes.
3. Cervical dysfunction In a non-pregnant state, the internal cervical orifice can be expanded to 8.0 without resistance, and cervical dysfunction can be diagnosed. Cervical dysfunction is mainly manifested as laxity of the internal orifice and absence of the isthmus.
4. Abnormal intrauterine pressure, with uneven intrauterine pressure, is commonly observed in cases of dystocia and abnormal fetal position.
Hypertension within the uterine cavity is commonly observed in twin pregnancies, polyhydramnios, and severe coughing and constipation.
5. Trauma and mechanical stimuli can be classified into two main categories: medically induced and non-medically induced.
Non-medical causes are commonly associated with sexual activities in the late stages of pregnancy.
Medical interventions, including multiple amniocenteses, multiple vaginal examinations, and cervical dilation for induced labor, etc.
What should be done about premature rupture of membranes? Premature rupture of membranes can lead to several common complications, such as premature delivery, infection, and umbilical cord prolapse. The harm is significant. So what should be done about premature rupture of membranes? Let's take a look.
Generally, after rupture of membranes, labor usually occurs within 24 hours. No matter the gestational age at the time of rupture, it is not appropriate to prevent progress in labor.
1. For pregnant women with a high-lying presenting part, after membrane rupture, it is advisable to lie down and rest in bed, elevate the foot of the bed, and position the head lower than the buttocks to prevent cord prolapse, particularly for primiparas and those with twins.
2. Maintain vaginal cleanliness, and for women with rupture of membranes lasting more than 12 hours, antibiotics should be administered to prevent infection.
3. For pregnant women at 36 weeks of gestation who have not given birth within 24 hours, the rates of infection of amniotic and placental membranes, as well as perinatal mortality and morbidity, are all increased accordingly. To reduce the risk of infection and prevent complications for both mother and child, active induced labor should be undertaken.
If 36 weeks pregnant, the fetus is not mature, and the pregnant woman insists on keeping the pregnancy, under the premise of active monitoring and prevention of infection, absolute bed rest can be given to the patient, prophylactic uterotonics can be used, and the pregnancy can continue until the opportunity for promoting fetal lung maturity and cervical ripening occurs, which would be conducive to the prognosis of the perinatal infant.
If signs of amniotic inflammation occur, such as the maternal and fetal heart rate is accelerated, the fetal heart rate can reach 160bpm, uterine tenderness, uterine contractions, smelly amniotic fluid, purulent secretions from the vagina, white blood cell count can reach more than 15×10^9/L, C-reactive protein 2mg/dl, abortion should be carried out immediately, and cesarean section should be performed if necessary.
For those with breech presentation, cephalopelvic disproportion, pelvic contraction, and other obstetric complications, the doctor will make appropriate treatment based on the situation.
Prior to full term, premature rupture of membranes can be managed with expectant treatment or termination of pregnancy as appropriate.
At full term, premature rupture of membranes requires an appropriate method for termination of pregnancy, either induced labor or cesarean section.
In any case, prophylactic antibiotics should be used if the membrane rupture exceeds 12 hours.
The dangers of premature rupture of membranes (PROM) occur in pregnant women at any stage of gestation, but are most commonly associated with labor or delivery. PROM refers to the rupture of the amnion and chorion, resulting in the sudden leakage of amniotic fluid from the vagina. The incidence of PROM is approximately 2.7-17%, representing a severe complication during late pregnancy and posing a great threat to both mother and fetus. Therefore, it is imperative that this condition not be underestimated.
For the mother, the most severe consequence of premature rupture of membranes is infection. It manifests as fever, leukocytosis, uterine tenderness, accelerated fetal heart rate, and foul-smelling amniotic fluid. The causative pathogens originate from the vagina or vulva area, often accompanied by a bacteremia phenomenon.
The greatest threat to a premature infant from an unmature fetus is preterm delivery.
For mature fetuses, premature rupture of membranes poses a threat in that it can lead to amniotic fluid deficiency, resulting in intrauterine distress for the fetus. Moreover, it is prone to postnatal sepsis, pneumonia, and respiratory distress syndrome, leading to a significant increase in perinatal mortality rate.
Additionally, premature rupture of membranes is a signal for difficult labor. This is due to the presence of factors predisposing to labor such as an unfavorable breech presentation, high fetal head position, and other conditions that increase the likelihood of premature rupture of membranes. Premature rupture of membranes, in turn, leads to reduced amniotic fluid volume, infection, and intrauterine distress, all of which contribute to an increased incidence of difficult labor and cesarean delivery. Thus, it can be seen that premature rupture of membranes is interconnected with difficult labor.
The dangers of premature rupture of membranes are significant, and if expectant mothers notice any signs of this condition, they must seek medical attention and take appropriate measures promptly.
How is premature rupture of membranes diagnosed? If a woman suspects she has premature rupture of membranes, the doctor will generally require her to undergo certain tests for specific diagnosis: 1. Testing of vaginal discharge pH value: This can be determined using a test strip, and if the pH value is ≥7, it often indicates rupture of the membranes. Since the vaginal pH is between 4.5 and 5.5, while amniotic fluid is between 7 and 7.5.
2. After the vaginal smear preparation has dried and examined under a microscope, the presence of needle-like crystals is observed. The application of 0.5‰ methylene blue stain reveals faint blue or unstained fetal epithelium and hairs.
When stained with 0.1% - 0.5% nigrosin, the presence of yellowish-orange cells in amniotic fluid is diagnostic of premature rupture of membranes.
Intraamniotic instillation of indigo carmine, if escaping through the vagina, permits definite diagnosis.
The medical part covered in this article is for reading and 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.