Rupture of Membranes

I think my waters have gone!

Bek Cook_thumb

Rupture of membranes (ROM) or “waters have gone” refers to the leaking of amniotic fluid (‘liquor’) from the amniotic sac around your baby because of a hole that develops in the amniotic membrane.

It is a normal phenomenon during labour. In about 10% of cases will happen before the onset of labour. Sometimes it happens much earlier in the pregnancy which creates a situation of considerable risk for the baby.

If it is a forewater leak (a hole in the membrane just inside the cervix) then the amount of liquor released is considerable. It often happens in labour. If it happens before labour, it is likely labour will soon start even if the pregnancy is not that advanced. There is risk of infection ascending from the vagina into the amniotic sac where your baby is.  As a consequence if there is prolonged ROM then you will be checked for infection  and antibiotics will be prescribed to safeguard your baby’s wellbeing. If you have Group B Steptococcus in your vagina then intravenous antibiotic prophylactic therapy will be strated as soon as you arrive at the hospital.

As well, with a gush of liquor and particularly if the baby’s head is not well applied to the cervix, there is the risk of umbilical cord prolapse and compression which is very dangerous for your baby.

Sometimes it is a hindwater leak. This means the puncture is higher up in location, remote from the cervix. The amount of liquor that is released with a hindwater leak is usually minimal. Indeed sometimes vaginal discharge is confused with liquor. The liquor tends to be clear and have a fishy like smell. As well there can be special checking done in Labour Ward/Birth unit to clarify. There is less risk to the baby of infection but you still need to attend the hospital. If you have Group B Steptococcus in your vagina then intravenous antibiotic prophylactic therapy will be strated as soon as you arrive at the hospital.

If there is a hindwater leak before term gestation there is a chance that the hole could seal over and so the pregnancy could continue.

What your should do

If you suspect you have ruptured membranes either forewater or hindwater you must contact the Labour Ward/Birth Unit midwifery staff so the situation can be assessed and it decided in consultation with me what appropriate action should be taken.

Alos see Group B Strep in the Questions and Answers section

Posted by Dr Gary Sykes on -