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Premature Rupture of Membranes
WHAT YOU SHOULD
KNOW
During pregnancy, the developing baby is protected by a
fluid-filled sac called the bag of waters, or the "membranes."
This bag usually stays intact until several hours before labor
starts---or even for a while after labor has begun---but it can
burst or start leaking any time during the pregnancy.
Once the membranes rupture, labor usually starts within
12 to 24 hours. If labor doesn't begin during this period, the
situation is called premature rupture of membranes
(PROM).
Causes
We don't know what causes the membranes to break ahead of
time. However, it's more likely to happen in women who have had
several children, and in those with a vaginal infection.
There's also a greater chance of it if the baby is in a breech
position (feet first), or if you've had an amniocentesis
(AM-nee-oh-sen-Tee-sus).
Signs/Symptoms
You may feel either a slow trickle or a sudden gush of
warm fluid from your vagina.
Care
The doctor will probably want to test a sample of the
fluid to make sure the bag of waters has broken; and you may
need an ultrasound to check the amount of fluid around the
baby. A stay in the hospital may be
necessary.
Risks
You or the baby could get an infection after your
membranes break. However, the risks of serious problems are
small if you follow your doctor's
advice.
WHAT YOU SHOULD
DO
-
Do
not have sex until your doctor says it's
OK.
-
The doctor will probably want
you to check how often the baby moves. Lie down several
times a day for a few minutes. Write down how many times
the baby moves or kicks.
-
You'll need to check your
temperature. The doctor will tell you how often to take
it.
-
Be careful to guard against a
vaginal infection. Take the following
steps:
-
-
Change your sanitary pad
every 1 to 2 hours.
-
Take showers instead of
tub baths.
-
Do not douche or put
anything in your vagina.
-
Wipe from front to back
after using the bathroom.
-
If the doctor prescribes
medicine, take it exactly as directed. If you feel it is
not helping, tell the doctor, but do not quit taking it on
your own
-
If the doctor prescribes
antibiotics, take them until they are all gone---even if
you feel better.
-
If you are taking medicine
that makes you drowsy, do not drive or use heavy
equipment.
Call Your Doctor
If...
-
You have a high
temperature.
-
You are having contractions
(abdominal pain that comes and goes).
-
Your baby does not move very
frequently in 24 hours.
IF YOU'RE HEADING FOR THE
HOSPITAL...
What to Expect While You're
There
You may encounter the following procedures and equipment
during your stay.
-
Taking Vital Signs: These include your temperature,
blood pressure, pulse (counting your heartbeats), and
respirations (counting your breaths). A stethoscope is used
to listen to your heart and lungs. Your blood pressure is
taken by wrapping a cuff around your
arm.
-
Pelvic Exam: This is also called an "internal" exam.
Your doctor will gently put a warmed speculum (SPEK-u-lum)
into your vagina. This tool opens your vagina to let your
doctor see your cervix (the bottom part of your uterus). He
or she will take a sample of the fluid in your vagina and
have it tested to determine whether your bag of waters has
broken.
-
Fetal Heart Monitoring: A loose fitting belt with a
small metal disc may be placed around your abdomen to
monitor the baby. The disc sends signals to a TV-like
screen that shows a tracing of the baby's
heartbeat.
-
Abdominal Ultrasound: This painless test uses sound
waves to view the inside of your abdomen. Pictures of the
area show up on a TV-like screen.
-
Activity: You may be asked to stay in bed. The
doctor will tell you when it's OK to get
up.
-
Blood Tests: You may need blood taken for tests. It
can be drawn from a vein in your hand or from the bend in
your elbow. Several samples may be
needed.
-
IV: A tube placed in your vein for giving medicine
or liquids. It will be capped or have tubing connected to
it.
-
Medicines:
-
Antibiotics: These help you fight bacterial
infection. They may be given by IV, as a shot, or by
mouth.
-
Other: If you are 36 or more weeks pregnant, the
doctor may give you medicine to help you go into
labor.
-
Stress: The hospital can cause a lot of stress. Try
controlling it through such methods as deep breathing,
muscle relaxation, meditation, or biofeedback. If you feel
anxious and worried, try talking about it. Sharing can
help.
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