Anyone know about PROM(premature reputure of the membrane) when pregnant?

Question

My daughter had this to happen when she was 25 wks pergnant and now is 26 wks and still in hospital because of this. The problem is they don't know if she is reproducing any water for the baby? It's my understanding that this means there is no water around the baby or water for him to float in. Do you know anything or have had this to happen to you or someone else? I am wondering if they should let the baby stay in there like this? Like could something go wrong or harm him if he isn't born yet? I know it's better for him to stay there and grow some more but i worry that they could wait too long? They keep a heart monitor hooked to her to check his heart rate at almost all times except for bathroom breaks and showers. so thats good! But you know you still wonder if all is well with him staying like that? I've never had this or heard of it before, when my water broke with my first child i was 8 mos along and i didn't go into labor so they did a emergency c-section for me?

In case the Obgyn that answered this question reads this, i wanted to ask what if there is no fuild and she may not be reproducing any ? Is this going to hurt the baby? They said something about his kidneys may not be working ?

Answer 1

I am an ob/gyn and can help you out with this question. When PROM occurs before 34 weeks, it is a very tricky situation and that is why your daughter will be staying in the hospital until she delivers for very close monitoring.

The issue is the risk of prematurity versus the risk of infection. As long as your daughter doesn't develop an infection in the uterus, she doesn't go into labor, and the baby continues to grow, it is best to keep the baby inside to increase the chances that baby will do well. However, if an infection develops or the baby has any distress, it will be time to get the baby delivered.

If the baby is breech, without enough fluid, it is unlikely that the baby will turn, so that means the baby will need to be delivered by C-section. If the baby is head-down, then your daughter can attempt a vaginal delivery.

Best of luck with the birth of your grandchild....

ADDENDUM TO THE ASKER: To address your additional question about whether there is a problem with the baby's kidneys: most of the time when the water breaks, the fluid can reaccumulate to a small degree with bedrest. After all, a normal baby would be making fluid by producing urine. However, sometimes (in very rare and unusual situations), no fluid reaccumulates even after bedrest. This can be a bad sign. First of all, you have to wonder if the kidneys are functioning well because they are responsible for making urine that ends up as amniotic fluid. Secondly, if there is absolutely no fluid around the baby, the lungs will have trouble developing. When the baby breathes fluid in and out of the lungs while in the uterus, this helps create the lung spaces where air will enter after birth. If this is what is happening with your daughter, then her doctors may choose to get her delivered, even if the baby is preterm. This can be an extremely tough decision to make, but sometimes, babies do better on the outside and certainly, the neonatalogists would be better able to evaluate the kidneys and lungs after the baby is delivered. My heart goes out to you....Please keep us posted on what happens. My email is [e-mail]. Thanks.

Answer 2

My membranes ruptured at 25w and I was on hospital bedrest until I delivered spontaneously at 31w. My DS is now 5y old and healthy.

At that gestational age, they'll only do a section (or induce) if baby shows signs of distress because of infection. It's much better for baby to remain inside, growing. A 26-week baby isn't mature enough to survive outside the womb w/o medical intervention and a long NICU stay. The survival rate of a 26-weeker is approx. 60%.

Amniotic fluid continues to be made. It comes from baby's urine and...I forget what else. Lacking fluid, the walls of the uterus lean it on baby. A couple doctors told me about cases where this led to deformities in the developing baby; I think it made my DS stronger. He's all muscle. Amniotic fluid is important for lung development.

Your DD's doctors will probably do periodic u/s's to check for fluid pockets/levels and baby's growth. Has she had steroid shots to help mature baby's lungs? And IV antibiotic prophylaxis for any uterine infection?

Does she know if she's having a girl or boy? Preemie girls have better NICU outcomes than boys.

Best to your DD and to you. Hospital bedrest is tough, it's such a shocker. Congratulations on the little one to be and hope that baby stays baking a few weeks longer.

Answer 3

it is safer for the baby to stay in than to be born this early
my son is now 5 months old and he was born 10 weeks and 4b days early my water broke on sept 7 2006 he was born sept 18th 2006...i was very scared when they said that they were going to stop the labor and try to wait untill i was 36 weeks before delivery i had never heard of this..i have 7 children in all and 4 were born prematurly but he is the only one that they did not let deliver right after my water broke i asked the nicu dr for information showign that it is safer to leave the baby in he gave me some paperwork from www.compleatmother.com/prom.htm
and some other sites i am looking for them but it showed that so long as they are in the womb the actually gain weight faster and are safer in side...if they are monitornign heart beat and avoiding pelvic exams and she still feels the baby is moving i would say let the baby stay in the baby continues to reproduce amonitic fluid it is the babys urin
good luck and i wish you and your daughter the best it is going to be a long road ahead

Answer 4

http://www.kanalen.org/prom/index.php This is a fantastic website all about PROM written by women who have experienced it themselves.