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Premature Rupture of Membranes


Overview :

During pregnancy, the unborn baby (fetus) is surrounded and cushioned by a liquid called amniotic fluid. This fluid, along with the fetus and the placenta, is enclosed within a sac called the amniotic membrane. The amniotic fluid is important for several reasons. It cushions and protects the fetus, allowing the fetus to move freely. The amniotic fluid also allows the umbilical cord to float, preventing it from being compressed and cutting off the fetus's supply of oxygen and nutrients. The amniotic membrane contains the amniotic fluid and protects the fetal environment from the outside world. This barrier protects the fetus from organisms (like bacteria or viruses) that could travel up the vagina and potentially cause infection.

Although the fetus is almost always mature at between 36-40 weeks and can be born without complication, a normal pregnancy lasts an average of 40 weeks. At the end of 40 weeks, the pregnancy is referred to as being term. At term, labor usually begins. During labor, the muscles of the uterus contract repeatedly. This allows the cervix to begin to grow thinner (called effacement) and more open (dilatation). Eventually, the cervix will become completely effaced and dilated. In the most common sequence of events (about 90% of all deliveries), the amniotic membrane breaks (ruptures) around this time. The baby then leaves the uterus and enters the birth canal. Ultimately, the baby will be delivered out of the mother's vagina. In the 30 minutes after the birth of the baby, the placenta should separate from the wall of the uterus and be delivered out of the vagina.

Sometimes the membranes burst before the start of labor, and this is called premature rupture of membranes (PROM). There are two types of PROM. One occurs at a point in pregnancy before normal labor and delivery should take place. This is called preterm PROM. The other type of PROM occurs at 36-40 weeks of pregnancy.

PROM occurs in about 10% of all pregnancies. Only about 20% of these cases are preterm PROM. Preterm PROM is responsible for about 34% of all premature births.




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