How Long Can the Baby Stay in the Womb After the Water Has Already Broken

This information is for you if yous think that, or have been told that, your waters have broken early but y'all take non gone into labour.

It may also exist helpful if you are a partner, friend or relative of someone who is in this state of affairs.

This applies to you if your waters may take broken between 24 and 37 completed weeks of pregnancy.

If your waters interruption before 24 weeks, yous should take a discussion with your healthcare professional about your individual circumstances.

See a full glossary of medical terms.

The information hither aims to help y'all better understand your health and your options for handling and intendance. Your healthcare team is there to support you in making decisions that are right for you. They tin aid by discussing your situation with you and answering your questions.

This data covers:

What Preterm Prelabour Rupture of Membranes (PPROM) is
What you should do if you lot have PPROM
What happens at hospital and if PPROM is diagnosed
What PPROM could mean for y'all and your infant
Treatment options
Information well-nigh giving birth
What PPROM means for future pregnancies
Further information and support available

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Key points

Preterm prelabour rupture of membranes (PPROM) is when your waters break before 37 completed weeks of pregnancy but yous haven't gone into labour yet.
If this happens, you have a higher gamble of giving birth prematurely and there is an increased chance that both you and your baby may develop an infection that tin make yous both unwell.
You volition be offered a course of antibiotics to reduce the take chances of an infection developing and to assist the pregnancy to go along.
If you are well with no signs of infection and your baby is growing well in your uterus (womb), then information technology may be improve to permit your pregnancy to continue until 37 weeks. You will be monitored very closely for whatever signs of infection by your healthcare team, and your individual circumstances and preferences will be taken into account.
If you lot or your baby evidence any signs of infection or develop other complications, you may need to give nativity to your baby directly away.

What is preterm prelabour rupture of membranes (PPROM)?

Your baby is surrounded by amniotic fluid or 'waters' contained within a membrane bag (the amniotic sac) inside your uterus.

When the waters pause, information technology is also known every bit rupture of the membranes.

Normally your waters break soon before or during labour.

If your waters break earlier labour at less than 37 weeks of pregnancy, this is known as preterm prelabour rupture of membranes (PPROM).

This can happen in upward to 3 out of every 100 (3%) pregnant women.

PPROM is associated with iii-4 out of every 10 preterm births.

The reason why PPROM happens is not always known, just may be because of infections, placental problems or other causes.

Diagram showing a infant in the womb, marking the placenta, umbilical cord, amniotic sac and amniotic fluid:
Diagram of a baby in the womb

How will I know if my waters have broken?

You may notice a 'gush' of fluid or you may feel damp. The amount of fluid you lose may vary from a trickle to a gush.

What should I practise?

If you recall that you are leaking fluid from the vagina, wearable a pad not a tampon and note the color and amount of the fluid.

Leaking urine is mutual while you're meaning, but if you lot think your waters may take broken, you lot should contact your healthcare professional and become to the hospital for a check-upwards straight away.

What happens at the hospital?

You will accept a check-up that should include:

a discussion with your healthcare professional almost what has happened, including details about the fluid loss, how yous are feeling, how your pregnancy has been so far and whether y'all take any risk factors for PPROM or preterm birth (for example, if this has happened in previous pregnancies it is more probable to happen over again)
a bank check of your general health, including an exam and a cheque of your temperature, pulse and blood pressure
a cheque of your infant'south heartbeat.

How is PPROM diagnosed?

PPROM is best diagnosed by a vaginal examination. With your consent, your healthcare professional will utilize a sterile speculum (an instrument used to separate the walls of the vagina) to wait at your cervix and see whether the leaking fluid is amniotic fluid.
A swab exam of the fluid may help to determine whether your waters take broken, if it is yet unclear after the speculum exam.
An ultrasound scan to guess the corporeality of fluid around your baby is sometimes helpful.

What happens adjacent?

If your waters take broken, you volition usually be brash to stay in infirmary for a few days, although in some situations this may be for longer.

You lot and your baby will be closely monitored for signs of infection.

This will include having your temperature, blood force per unit area and pulse taken regularly, together with claret tests to bank check for infection.

Your baby'due south heart rate will as well be monitored regularly.

If your waters have not cleaved, you should be able to go home.

If simply a very small corporeality of amniotic fluid is leaking, information technology is not always piece of cake to see on examination and it can be difficult to confirm whether your waters have broken.

If you continue to leak fluid at dwelling house, you lot should return to the hospital for a further check-upward.

What could PPROM mean for me and for my infant?

Infection

The membranes form a protective barrier effectually the baby, and after these have broken, there is a risk of infection getting into your uterus (chorioamnionitis). If you have an infection, this can cause you lot to go into labour early or cause you or your baby to develop sepsis.

The symptoms of infection include a raised temperature, an unusual vaginal discharge with an unpleasant scent, a fast pulse rate and pain in your lower abdomen. Your baby's heart charge per unit may besides exist faster than normal.

If there are signs that yous take an infection, your babe may demand to be born directly abroad to try to prevent both you and your baby condign more than unwell.

Preterm birth

About l% of women with PPROM will get into labour within the first week after their waters pause. The further along you lot are in your pregnancy the more likely you are to go into labour within 1 calendar week of your waters breaking.

Issues of prematurity

Babies born prematurely have an increased risk of wellness problems, especially with breathing, feeding and infection, and may need admission to a neonatal unit. The earlier your babe is born, the more than probable that this volition be the instance.

If your waters have broken early, your healthcare professional volition hash out with you the possible outcomes for your babe, depending on how many weeks meaning y'all are when this happens and on your individual circumstances.

Other complications

String prolapse, when the umbilical cord falls through your cervix into the vagina: this is an emergency complexity and can exist life-threatening for your baby, only it is uncommon.
Pulmonary hypoplasia, when your babe's lungs neglect to develop normally considering of a lack of fluid effectually them: this is more common if your waters break very early on in pregnancy (less than 24 weeks) when your infant'south lungs are nevertheless developing.
Placental abruption, when your placenta separates prematurely from your uterus: this can crusade heavy bleeding and can be dangerous for both you lot and your babe.

If yous feel PPROM, sometimes your babe may not survive. The gamble of this happening is greater if your waters break very early, if the baby is born very prematurely or, in some cases, following infection or cord prolapse.

Are there any treatments for PPROM?

It is non possible to supplant the fluid or repair the hole in the membranes around your infant. You may deport on leaking fluid for the residual of your pregnancy equally amniotic fluid continues to be made.

However, treatment may be offered to reduce the risk to your baby. This could include:

a course of antibody tablets to reduce the run a risk of an infection getting into the uterus and affecting both y'all and your baby; antibiotics can also help to delay you going into labour
a course of steroid injections (corticosteroids) to help with your babe's development and to reduce the chance of problems caused by being built-in preterm; meet the RCOG patient data Corticosteroids in pregnancy to reduce complications from being born prematurely
magnesium sulfate, a medication that may exist offered to you if your baby is at risk of being born very prematurely; this tin can reduce the take a chance of them developing cerebral palsy
intravenous antibiotics (if y'all are in preterm labour) to reduce the risk of early-onset group B Streptococcus (GBS) infection; see the RCOG patient information Group B Streptococcus (GBS) in pregnancy and newborn babies.

Exercise I need to stay in hospital?

Y'all will usually be advised to stay in hospital for a few days after your waters intermission, to monitor both your and your baby's wellbeing. Your healthcare professional person will discuss with you the option of going habitation afterward this time, if you lot are well and non considered to be at higher gamble for giving nascency early.

When should I seek help if I go dwelling house?

Before going home from infirmary, your healthcare professional will give you information on symptoms to look out for. Contact your healthcare professional person and return to the hospital immediately if yous experience any of the following:

raised temperature
flu-like symptoms (feeling hot and shivery)
vaginal haemorrhage
if the leaking fluid becomes greenish or smelly
contractions or cramping pain
abdominal hurting or back pain
if you are worried that the infant is non moving as normal.

What follow-up should I have?

You should accept regular check-ups with your healthcare professional (normally one or two times per week).

During these check-ups, your babe'due south center rate will be monitored, your temperature, pulse and blood pressure will be checked and you volition have claret tests looking for signs of infection.

Your obstetrician will work with you to make an ongoing plan for your pregnancy.

Experiencing PPROM can exist a very stressful time for both you and your family.

You should exist offered emotional support during your pregnancy and afterwards your babe is born.

If y'all are worried near how you are feeling, do seek help from your healthcare professional and support groups (run across links below).

When is the right time to give nativity?

If you and your babe are both well with no signs of infection so y'all may be advised to look until 37 weeks to give birth. This is because conveying on with the pregnancy reduces the take a chance to your baby that are related to beingness born preterm.

If you are known to behave the GBS bacteria, then you may exist advised to give nascence from 34 weeks because of the hazard of GBS infection in your infant. Come across the RCOG patient information Group B Streptococcus (GBS) in pregnancy and newborn babies.

Your healthcare professional person should discuss the timing of birth with you lot depending on your individual circumstances and preferences. You will have the opportunity to enquire whatever questions you have about your pregnancy and near preparing for birth.

Will I exist able to accept a vaginal birth afterward PPROM?

Information technology is ofttimes possible to have a vaginal nascency after PPROM but this will depend on when you get into labour, the position your baby is lying in in your uterus, and your own individual circumstances and choices.

Your healthcare professional volition discuss this with you.

How will this affect whatever future pregnancy?

Having PPROM or giving birth prematurely means that you lot are at an increased take chances of having a preterm birth in any future pregnancies.

Y'all will be advised to be under the care of a specialist team who volition talk over with y'all a programme for your pregnancy depending on your individual state of affairs.

About intimate examinations

The nature of gynaecological and obstetric care means that intimate examinations are oft necessary.

We sympathize that for some people, particularly those who may take anxiety or who have experienced trauma, physical corruption or sexual abuse, such examinations tin be very difficult.

If y'all experience uncomfortable, anxious or distressed at any time before, during or after an examination, please let your healthcare professional person know.

If you observe this difficult to talk most, you may communicate your feelings in writing.

Your healthcare professionals are in that location to assist and they can offering culling options and support for you.

Remember that you can e'er ask them to stop at any time and that you are entitled to enquire for a chaperone to be present. You lot can also bring a friend or relative if you wish.

Further information

Little Heartbeats: www.little-heartbeats.org.uk

Group B Strep Support (GBSS): https://gbss.org.uk

SANDS: world wide web.sands.org.uk

The UK Sepsis Trust: https://sepsistrust.org

The Birth Trauma Clan: www.birthtraumaassociation.org.u.k.

Dainty guideline NG25, Preterm Labour and Birth: world wide web.prissy.org.uk/guidance/ng25

RCOG Green-meridian Guideline No. 73, Care of Women Presenting with Suspected Preterm Prelabour Rupture of Membranes from 24⁺⁰Weeks of Gestation

RCOG patient information, Umbilical cord prolapse in late pregnancy

A total list of useful organisations is available on the RCOG website at www.rcog.org.uk/en/patients/other-sources-of-assistance

Shared Decision Making

If you are asked to make a option, you may have lots of questions that you desire to ask. You may likewise want to discuss your options with your family or friends. It can assistance to write a list of the questions you desire answered and take it to your appointment.

Ask 3 Questions

To begin with, try to make sure you become the answers to 3 key questions, if you lot are asked to make a choice about your healthcare:

What are my options?
What are the pros and cons of each selection for me?
How do I get back up to aid me make a decision that is right for me?

*Ask 3 Questions is based on Shepherd et al. Three questions that patients can inquire to improve the quality of information physicians give about treatment options: A cross-over trial. Patient Education and Counselling, 2011;84:379-85

https://www.aquanw.nhs.uk/sdm

Sources and acknowledgements

This information has been developed by the RCOG Patient Data Committee. It is based on the RCOG Green-tiptop Guideline No. 73, Intendance of Women Presenting with Suspected Preterm Prelabour Rupture of Membranes from 24⁺⁰ Weeks of Gestation, published in June 2019. The guideline contains a full list of the sources of evidence we have used.

This information has been reviewed before publication by members of the RCOG Women's Network and the RCOG Women's Voices Involvement Panel and by women attending clinics across the Great britain.

How Long Can the Baby Stay in the Womb After the Water Has Already Broken

Source: https://www.rcog.org.uk/en/patients/patient-leaflets/when-your-waters-break-prematurely/