Your Water Breaks First - A Date to PROM (Premature Rupture of Membranes) - What is PROM?

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While you are pregnant your baby is enclosed in a membranous sac filled with amniotic fluid, this sac cushions and protects the fetus while they are in utero, it is referred to by varying terms from your water bag to your amniotic sac.

These fetal membranes are designed to weaken towards the end of pregnancy and most commonly pressure from contractions during labor will cause the membranes to give way at a weak spot.

In medical terms “your water breaking” is termed as Rupture of Membranes (ROM) and this can happen at any time during pregnancy and has been experienced by women in all three trimesters.

For a variety of known but often unknown reasons, a rupture of membranes can happen at any time—it can happen pre-term, it can signal the start of labor, it can break during labor, it can be artificially broken by your caregiver, and it is possible that your baby is born with the amniotic sac still intact (born in the caul).

This post will mainly concern itself with at term premature ROM but I am also including a brief discussion of pre-term premature ROM.

In medical terms, when your “water breaks first” at term, which is characterized as  ≥37 weeks, you are classified as a term Premature Rupture of Membranes (term PROM). This is not a very common occurrence, whatever Hollywood (or my statistics) would like us to believe, typically only one in 10 women or 8-10% will begin labor in this manner.

When your water breaks at ≤37weeks, you are classified as pre-term Premature Rupture Of Membranes (PPROM).  According to The PPROM Foundation pre-term PROM is responsible for 30-40% of pre-term births and typically affects 2-4% of singleton pregnancies and up to 20% of twin pregnancies.

As I stated earlier, PPROM is a genuine medical emergency, you need to be calling your caregiver on the way to the hospital, and from there determine your best decisions for moving forward.

The rest of this article will concern itself with educating readers on all the relevant issues surrounding the discussion and debate on whether all cases of term PROM should be actively managed with induction immediately following rupture or whether women with non-complicated singleton pregnancies who meet certain criteria upon rupture should be expectantly managed, taking a hands off approach and waiting— letting labor/contractions begin on their own.