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Premature rupture of membranes, risk factors and treatment

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Premature rupture of membranes occurs when the pregnancy is not yet 37 weeks old. Conditions that can harm both mother and baby can be caused by several things. Handling also needs to be adjusted to the age of the womb when the membranes rupture.

Amniotic fluid is the fluid in the pouch that surrounds the fetus in the womb. Under normal conditions, the amniotic sac will rupture just before delivery. However, there are times when the membranes rupture faster than the time it should or what is known as premature rupture of the membranes.

A pregnant woman is said to have premature rupture of membranes if:

  • The fluid has leaked before the pregnancy reaches 37 weeks. The earlier the membranes rupture, the more dangerous it is for the mother and her baby
  • The membranes rupture when the gestational age is approaching the due date, but there is no delivery within 24 hours afterward

Causes and risk factors for premature rupture of membranes

The exact cause of premature rupture of membranes is still not clearly known, but this condition is thought to arise due to weakening of the amniotic sac or excessive pressure around the membranes, for example due to uterine contractions.

In addition, there are several factors that can increase the risk of premature rupture of membranes, namely:

  • Presence of infection in the placenta, urinary tract, uterus, cervix, or vagina
  • Too much amniotic fluid volume (polyhydramnios) or multiple pregnancies, causing the uterus and amniotic sac to stretch too much
  • Pregnant women with low body weight or underweight
  • Habit of using illegal drugs or smoking during pregnancy
  • Have had a biopsy or surgery on the cervix (cervix)
  • Short cervix
  • Have you experienced premature rupture of membranes before?
  • Have experienced bleeding during pregnancy, especially in the second and third trimesters

Handling of premature rupture of membranes

Handling of premature rupture of membranes will usually be adjusted to the gestational age, condition of the fetus in the womb, and the health condition of the mother.

The following are some of the treatments that doctors will do based on the time of premature rupture of membranes:

1. Gestational age less than 23 weeks

If the membranes rupture prematurely before 23 weeks of pregnancy, the doctor needs to evaluate the condition of the mother and fetus to determine whether a high-risk pregnancy is maintained.

It is unlikely that babies born at this gestational age can survive. If they are able, they are more likely to have mental or physical disabilities.

In premature rupture of membranes at a very young gestational age, the doctor may give drugs to relax the uterus and additional amniotic fluid (amnioinfusion).

2. Gestational age 23–34 weeks

If the membranes rupture prematurely at this gestational age, the doctor will usually suggest delaying the birth so that the fetus in the womb has enough time to grow and develop.

Pregnant women will be given antibiotics to prevent infection and corticosteroid drugs to accelerate the development of the fetal lungs.

3. 34–37 weeks gestation

The doctor will likely suggest induction of labor so that the baby is delivered a few weeks early if the membranes rupture prematurely. This is done to prevent the baby from getting infected.

4. Gestational age more than 37 weeks

If premature rupture of membranes occurs when the gestational age is past 37 weeks, the fetus in the womb needs to be delivered immediately. The longer the delivery process is carried out, the greater the chance for pregnant women and the fetus to be infected.

Pregnant women who are at risk of premature rupture of membranes as mentioned above, are recommended to undergo routine pregnancy check-ups and consult a doctor. This aims to avoid premature rupture of membranes and the complications that it can cause.

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