by Keisha Richards

Created on: December 22, 2009   Last Updated: December 24, 2009

PROM, according to my own research and personal experience with it, occurs during pregnancy when the amniotic sac ruptures more than an hour before the onset of labor and when a woman is beyond 37 weeks gestation. This occurs in about 10% of all pregnancies. PROM stands for Premature Rupture of Membranes and is considered prolonged if it happens more than 18 hours before the onset of labor.

PROM should not be confused with PPROM, which is Preterm Premature Rupture of Membranes and occurs before 37 weeks gestation. I personally experienced prolonged PPROM. My membranes ruptured at 32 weeks gestation and I waited an entire week for labor that never came. My son was born via cesarean section as my daughter was.

Signs of PROM include leakage of fluid from the cervix and vagina, vaginal discharge, bleeding, and pelvic pressure, but not contractions. Diagnosis of PROM can be made by vaginal examination.  If fluid is pooling or leaking from the vaginal cavity, there is a good chance that the patient's membranes have ruptured. 

There is also a test that can be done with Nitrazine paper to test the alkalinity of the fluid and determine if the membranes have ruptured. If blood contaminates the Nitrazine paper, then an ultrasound can be performed to detect the absence or low amount of fluid.

Most patients go into labor within 24 hours of having their membranes rupture. The biggest risk with PROM is infection. The risk goes up with the amount of time the membranes are ruptured. The risk of infection with PROM has been reported as being less than 10%. 

However, this risk increases to 40% after the first 24 hours. It is thought that inducing labor when a patient experiences PROM can reduce the risk of infection in the uterus if the mother and the baby are both in stable condition. 

The prognosis for many cases of PROM is good since the mother is considered term at 37 weeks gestation when PROM occurs. Most babies' lungs are mature at 37 weeks and they are well enough to go home after birth.

If for some reason the baby's lungs are not mature at 37 weeks, it may be a good idea to practice conservative management with the mother.  Conservative management means keeping the mother pregnant for as long as possible while the baby matures enough to do well outside the womb. 

Of course, the mother will receive antibiotics to keep infection away and she may also receive steroid injections to help mature the baby's lungs more quickly should labor come or should delivery be necessary by cesarean section.

While the reason for PROM can sometimes not be determined, there are risk factors for PROM. Some risk factors are bacterial infection, defects in the amniotic sac, uterus, or cervix and smoking. It's important not to smoke while pregnant and to be sure to take a prenatal vitamin daily, stay hydrated, eat well, and report any unusual symptom to your doctor right away even if really don't think it's a big deal. 

It's also important for mothers to keep every appointment with their obstetrician so anything unusual or unhealthy can be taken care of right away and possibly prevent issues such as PROM during the pregnancy.

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