Rupture of Membranes

The amniotic sac provides a protective barrier around the fetus. When its membranes weaken and tear, amniotic fluid may leave as a gush or as a persistent trickle. Infection, over-distension of the uterus, and mechanical trauma are recognized contributors, although the precise cause is often not identifiable in an individual pregnancy. The lost barrier creates two immediate concerns. Bacteria can ascend from the vagina into the amniotic cavity, and reduced fluid can increase the risk of umbilical cord compression. Labour may also begin after the membranes rupture. The amount of fluid seen externally does not reliably indicate the amount remaining around the fetus; a small leak can still be clinically significant. The gestational-age distinction changes the plan: - PPROM is spontaneous rupture before 37+0 weeks. - Term PROM occurs at 37+0 weeks or later, generally before labour begins. The practical nurse should establish gestational age early because a suspected leak at 31 weeks is managed very differently from a similar leak at 39 weeks.