PROM

This is used for Premature Rupture Of Membranes, and Prolonged Rupture Of Membranes. Depends upon the medical facility, or midwife.  

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Premature Rupture of Membranes

…Is when the bag of waters breaks prior to the onset of labor. Prior to 37 weeks.

If it is a small leak, it is believed by some that it can reseal, but you are now at risk for infection since it has ruptured. Also there is a 30% chance that your baby can die. If the baby’s lungs are not mature as they need to be, the baby can have Respiratory Distress Syndrome. There is more of a chance for the cord to prolapse. This would require a C-section. You need to call your midwife right away!

 

You should be able to answer the following questions:

• How does it smell?

• How much fluid is leaking? Did it gush, or trickle?

• Do you have a temperature? or a Infection?

 

You will need to do the following:

IMPORTANT: CONTACT YOUR CARE PROVIDER!

     Most care providers will not allow you to go with ruptured membranes and no labor for longer than 18 hours without doing something to help start labor.  Some will go up to 24 hours. 

• Monitor your temperature. Every 4 hours thru the labor.

• Continue to eat, and drink good nourishing liquids also.

• Do NOT put anything into your vagina. This also means to limit vaginal exams, which can sometimes hinder an important diagnosis.

• Wash your hands well after using the bathroom.

• Take 250 mg of vitamin C every 2-3 hours. No more than 2 grams in 24 hours.

• Only use your toilet, (after having your husband clean it well) do not use public restrooms.

• Don’t use a peri pad, sit on a chux and change it often. Trapped bacteria is not good.

• Pay attention to how much your baby is moving.

 

Prolonged Rupture of Membranes

…Is when the bag of waters breaks 24 hours or more before the onset of labor.

Why do I want the bag of waters to stay intact thru the labor?

The bag of waters act as a shock absorber to the baby, allows the baby to move easier, prevents the cord from becoming compressed or prolapsing, and helps to regulate the babys temperature.

What causes my bag of waters to break early?

• Poor nutrition causes weak membranes

• Infection

• trauma

• trauma from penetration during sexual intercourse

• too much amniotic fluid (polyhydramnious)

• incompetent cervix

 

Why do we worry about this?

When your water bag breaks early, you now have a chance for infection to become introduced to the uterus and to the baby.  You can take extra zinc, and vit C. Both are important and required for strengthening the membranes. You do not wait to take them when a problem occurs, you begin to take them prior to a problem. You could take 15-25 mg of Zinc, and 500mg to 3000mg of Vit C. daily. If you do not go into labor on your own, you will need to talk with your midwife or Doctor to make a decision what you should be doing. PLEASE DO NOT wait to tell your care provider!

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Preterm Labor

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If at any time you begin to have contractions or any sign of labor prior to 37 weeks, you need to contact your midwife right away! Although many moms deliver babies prior to 37 weeks, that do just fine, some do not. Some babies born before 37 weeks will have problems with their respiratory system, meaning they may require help with ventilation.

 

signs of pre term labor can be:

• a back ache that does not go away.

• contractions that do not go away

• vaginal discharge, a change in type (watery, mucus, or bloody)  

• pelvic or lower abdominal pressure

• mild abdominal cramps with or without diarrhea

• rupture of membranes (your water breaks with a gush, or a trickle)

 

The following are some reasons that can cause pre-term labor:

• Previous preterm labor with another pregnancy or this one

• You are carrying more that one baby.

• You have had one or more second trimester induced abortions (the planned ending of a pregnancy)

• You have an abnormal cervix

• You have had a serious infection while pregnant

• You have an abnormal uterus

• You have had abdominal surgery during this pregnancy

• You have had bleeding in the second or third trimester of this pregnancy

• You are under weight or weigh less that 100 pounds

• You smoke cigarettes or use cocaine

• You have had little or no prenatal care.

 

Potential problems of having a pre-term baby  

• Asphyxia

• Apnea

• Hyaline membrane disease

• Jaundice

• Infection

• Poor temperature control

• Anemia

• Any problems that go with immaturity

If you have a cervix that will not stay closed during pregnancy, the doctors can place a suture or tie around the cervix to hold it closed. You must go into the doctor early in your pregnancy, do not wait.  Early medical care is important.

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