Premature Rupture of Membranes Definition, Reason, Symptoms, Treatment & Prevention
Understanding
Premature rupture of membranes is the rupture of the membranes before it is time to give birth. This can occur at the end of pregnancy or long before the time of delivery. A condition called preterm premature rupture of membranes occurs before 37 weeks of gestation.
In addition, if the condition of premature rupture of membranes occurs more than 12 hours before the time of delivery, it is called prolonged premature rupture of membranes. About 70% of cases of premature rupture of membranes occur at a gestational age old enough to cause preterm birth.
This condition can occur in all expectant mothers. Based on research, an average of 5-10% of women experience premature rupture of membranes and only 1% experience preterm premature rupture of membranes.
Symptom
Symptoms of premature rupture of membranes is the discharge of amniotic fluid seeping through the vagina. Amniotic fluid smells sweet and doesn’t smell like ammonia.
This fluid will not stop or dry because it continues to be produced until birth. But if you sit or stand, the fetal head that is already located below usually ‘stuff’ or ‘clogs’ the leak temporarily.
Not only discharge, this symptom is also accompanied by fever, profuse vaginal spotting, and abdominal pain. Sometimes expectant mothers who experience this condition also feel that the fetal heart rate is increasing rapidly. If this happens, you should immediately consult a doctor. This is a sign of infection that occurs due to premature rupture of the membranes.
The most common complication of premature rupture of membranes is before 37 weeks of gestation, which is respiratory distress syndrome. This complication can occur in 10-40% of newborns. The risk of infection to the fetus increases with premature rupture of membranes, especially at less than 23 weeks gestation.
Therefore, all pregnant women with premature rupture of membranes should be evaluated for possible inflammation of the umbilical cord and membranes. In addition, expectant mothers can also experience the occurrence of umbilical cord discharge. And at worst, premature rupture of membranes can increase the risk of fetal defects to fetal death.
Reason
The cause of premature rupture of membranes in most cases has not been found. Even so, there are several factors that are related to premature rupture of membranes, namely a history of premature birth, smoking, and bleeding during pregnancy.
Some other risk factors for premature rupture of membranes include:
• Incompetence in the cervical region
• Presence of excess amniotic fluid
• Patients with a history of premature rupture of membranes
• Abnormalities or damage to the membranes
• Multiple pregnancies
• Trauma
• Short cervix at 23 weeks gestation
• Infections during pregnancy such as bacterial vaginosis
Diagnosis
The doctor will carry out a complete examination in diagnosing premature rupture of membranes, starting from interviews, physical examinations, and supporting examinations. One of the checks is by directly examining the seeping liquid with nitrazine paper.
The function of this paper is to measure the pH so that the doctor can immediately determine whether the fluid seeping from the vagina is amniotic fluid or not. The normal pH calculation of the vagina is 4-4.7 while the pH of amniotic fluid is 7.1-7.3. Then, the doctor can also carry out an examination through ultrasound (USG), to confirm the amount of amniotic fluid in the uterus.
Treatment
Treatment for premature rupture of membranes requires professional staff and must be done by a doctor at the hospital. The obstetrician will discuss the treatment plan to be carried out. However, this depends on how old the pregnancy is and the signs of infection that occur.
There are two risks that can occur due to premature rupture of membranes, namely:
- Premature baby birth
To determine whether the occurrence of premature rupture of membranes results in an earlier birth process, the doctor will first do an examination. The first is an examination of the maturity age of the fetus. Premature birth should be done especially at 32-34 weeks of gestation. The end result of the fetus’s ability to live greatly determines the steps to be taken.
If the rupture of the membranes has caused contractions within 24 hours, then the pregnancy process has entered the final phase. The earlier the rupture of the membranes occurs, the longer the distance between the ruptured membranes and contractions.
If the actual due date has not arrived, the doctor will usually induce labor by administering a contraction stimulator within 6 to 24 hours after the rupture of the membranes. However, if the delivery date is already in, the doctor will immediately give an induction because a delay can increase the risk of infection.
Sometimes doctors will use steroid drugs to mature the age of the fetus so that premature birth can be carried out. Even so, the use of this drug is still a matter of controversy.
Recent studies have found that there is no increased risk of infection in the mother and fetus. These steroid drugs are actually useful for maturing the fetus, reducing the risk of respiratory distress syndrome in the fetus, and bleeding in the brain. - Infection with premature rupture of membranes
If the baby is immature, the doctor will advise the prospective mother to rest and not accelerate the birth process (if it is not yet time to give birth). To prevent infection, the doctor will suggest using antibiotics.
The use of these antibiotics serves to prevent infection after the incident. In addition, expectant mothers who receive antibiotics after premature rupture of membranes will benefit, namely the birth process is slowed down to 7 days. This reduces the incidence of adverse events in newborns.
Abstinence in premature rupture of membranes are as follows:
• Don’t try to do an internal examination yourself if you have premature rupture of membranes.
• Do not have sex or take a bath if you have premature rupture of membranes.
• When finished defecating or urinating, always clean from front to back to avoid infection from the rectum.
Prevention
To prevent premature rupture of membranes from occurring, you can do various things:
- Reducing activity at the end of the second trimester or the beginning of the third trimester of pregnancy period.
- If you experience vaginal discharge that itches and smells during pregnancy, consult a doctor immediately to prevent premature rupture of the membranes.
As first aid for premature rupture of the membranes, contact your doctor immediately if you feel fluid seeping from the vagina. Then use sanitary pads to absorb the amniotic fluid that comes out. It can also keep the vaginal area clean and avoid infection.