When your waters break early (pre-term pre-labour rupture of membranes)

What is pre-term pre-labour rupture of membranes?

It’s when your waters break before the start of labour. This mostly happens near to the date that your baby is due. If your waters break before labour and before 37 weeks, it’s known as pre-term pre-labour rupture of membranes (PPROM).

What happens if I have PPROM?

After initial assessment and treatment as an inpatient, your consultant will discuss with you whether to monitor your pregnancy via the Day Assessment Unit (DAU), make plans for you to give birth sooner.

We may recommend a 2-dose course of steroid injections to help mature your baby’s lungs if they’re premature. We may offer you a 10-day course of antibiotics to reduce the risk of infection.

What care will I get in the DAU?

We’ll usually ask you to attend the DAU twice weekly for assessment and monitoring.

This may include taking:

• your temperature, pulse and blood pressure
  blood tests to help determine if there is any infection
• a low vaginal swab (weekly) to exclude infection

We’ll also offer ultrasound scans at agreed intervals.

Other assessments may include:

• testing your urine
• monitoring your baby’s heartbeat (CTG monitoring)
• observing for any fluid loss.

If the midwife detects any abnormal findings, they’ll seek advice from the consultant team.

Please allow 1 to 3 hours for your appointment.

Further management

Your consultant will discuss the appropriate timing of your baby’s birth with you. Depending on your situation, your choices may include:

• continued monitoring in the DAU until labour starts spontaneously.
• induction of labour by 37 weeks of pregnancy.

What should I do at home?

It’s very important that you watch for:

• bleeding from your vagina
• abdominal pain
• change in the colour of your waters
• offensive smell of the waters
• fever above 37C (we’ll ask you to take your temperature twice a day)
• your baby not moving as normal
• feeling unwell, vomiting, flu-like symptoms
• contractions.

If you experience any of the symptoms above, you should contact the DAU during opening hours. Contact the Labour Ward outside opening hours. This is regardless of when your midwife or doctor last saw you.

You should:

• eat and drink normally
• shower and bathe as you would normally
• avoid sexual intercourse due to the risk of infection.

If you’re worried or have any concerns about your well-being or that of your baby, speak to us and get medical advice.

Reducing associated healthcare infections

Find out how you can help to reduce healthcare associated infections when visiting hospital