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Home / How Long Can a Baby Stay in the Womb After the Water Breaks

How Long Can a Baby Stay in the Womb After the Water Breaks

This information is for you if you remember that, or have been told that, your waters accept broken early merely y'all have 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 have broken betwixt 24 and 37 completed weeks of pregnancy.

If your waters intermission before 24 weeks, you should have a discussion with your healthcare professional about your individual circumstances.

Run across a full glossary of medical terms.

The information here aims to assist you lot amend understand your health and your options for treatment and care. Your healthcare squad is at that place to back up yous in making decisions that are right for yous. They can help by discussing your situation with you and answering your questions.

This information covers:

  • What Preterm Prelabour Rupture of Membranes (PPROM) is
  • What yous should practice if y'all have PPROM
  • What happens at hospital and if PPROM is diagnosed
  • What PPROM could mean for you and your infant
  • Treatment options
  • Information about giving nascency
  • What PPROM means for future pregnancies
  • Farther data 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 you lot haven't gone into labour withal.
  • If this happens, you have a higher take a chance of giving birth prematurely and in that location is an increased take chances that both you and your baby may develop an infection that can make you both unwell.
  • Yous will be offered a grade of antibiotics to reduce the gamble of an infection developing and to assist the pregnancy to continue.
  • If yous are well with no signs of infection and your baby is growing well in your uterus (womb), and so information technology may be better to let your pregnancy to continue until 37 weeks. You lot volition be monitored very closely for any signs of infection by your healthcare team, and your individual circumstances and preferences will be taken into account.
  • If you lot or your babe show any signs of infection or develop other complications, you may demand to give nascence to your baby straight away.

What is preterm prelabour rupture of membranes (PPROM)?

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

When the waters pause, it is likewise known as rupture of the membranes.

Normally your waters break presently before or during labour.

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

This can happen in up to 3 out of every 100 (iii%) significant women.

PPROM is associated with 3-4 out of every 10 preterm births.

The reason why PPROM happens is non always known, but may be because of infections, placental problems or other causes.

Diagram showing a babe in the womb, marker 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 do?

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

Leaking urine is common while you're pregnant, but if you lot retrieve your waters may have broken, you lot should contact your healthcare professional and go to the infirmary for a check-up straight away.

What happens at the infirmary?

Y'all will have a check-upward that should include:

  • a discussion with your healthcare professional about what has happened, including details about the fluid loss, how you are feeling, how your pregnancy has been so far and whether you have any risk factors for PPROM or preterm birth (for example, if this has happened in previous pregnancies it is more likely to happen over again)
  • a check of your full general health, including an test and a check of your temperature, pulse and blood pressure
  • a check of your baby's heartbeat.

How is PPROM diagnosed?

  • PPROM is best diagnosed past a vaginal exam. With your consent, your healthcare professional person volition utilise a sterile speculum (an instrument used to separate the walls of the vagina) to look at your neck and run across whether the leaking fluid is amniotic fluid.
  • A swab examination of the fluid may help to make up one's mind whether your waters have cleaved, if information technology is still unclear later the speculum examination.
  • An ultrasound scan to estimate the amount of fluid around your babe is sometimes helpful.

What happens side by side?

If your waters accept broken, yous will commonly be brash to stay in hospital for a few days, although in some situations this may be for longer.

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

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

Your infant's heart rate will besides exist monitored regularly.

If your waters have not broken, you should exist able to go abode.

If only a very small corporeality of amniotic fluid is leaking, it is not always like shooting fish in a barrel to see on examination and it can be difficult to confirm whether your waters have cleaved.

If you continue to leak fluid at abode, you should return to the infirmary for a further check-upward.

What could PPROM mean for me and for my baby?

Infection

The membranes form a protective barrier around the infant, and after these have broken, in that location is a gamble of infection getting into your uterus (chorioamnionitis). If you lot take an infection, this can cause you to get into labour early on or crusade 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 charge per unit and pain in your lower abdomen. Your infant'south heart rate may also exist faster than normal.

If there are signs that you have an infection, your baby may need to be built-in straight abroad to try to foreclose both y'all and your baby becoming more unwell.

Preterm nascence

Near 50% of women with PPROM will go into labour within the first week after their waters interruption. The further along yous are in your pregnancy the more than likely yous are to go into labour within ane calendar week of your waters breaking.

Issues of prematurity

Babies born prematurely accept an increased chance of health problems, especially with breathing, feeding and infection, and may demand admission to a neonatal unit of measurement. The before your baby is born, the more likely that this will exist the case.

If your waters have broken early, your healthcare professional person volition discuss with you the possible outcomes for your baby, depending on how many weeks pregnant you lot are when this happens and on your private circumstances.

Other complications

  • Cord prolapse, when the umbilical string falls through your cervix into the vagina: this is an emergency complication and can be life-threatening for your baby, just information technology is uncommon.
  • Pulmonary hypoplasia, when your baby's lungs fail to develop normally because of a lack of fluid around them: this is more than common if your waters break very early on on in pregnancy (less than 24 weeks) when your baby's lungs are still developing.
  • Placental abruption, when your placenta separates prematurely from your uterus: this can cause heavy bleeding and tin can be dangerous for both yous and your babe.

If you feel PPROM, sometimes your baby may not survive. The risk of this happening is greater if your waters break very early, if the baby is born very prematurely or, in some cases, post-obit infection or string prolapse.

Are there any treatments for PPROM?

It is not possible to replace the fluid or repair the hole in the membranes around your baby. You may carry on leaking fluid for the rest of your pregnancy as amniotic fluid continues to exist made.

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

  • a course of antibody tablets to reduce the risk of an infection getting into the uterus and affecting both you lot and your babe; antibiotics can too help to filibuster you going into labour
  • a class of steroid injections (corticosteroids) to help with your baby's development and to reduce the chance of issues caused by being born preterm; encounter the RCOG patient data Corticosteroids in pregnancy to reduce complications from being born prematurely
  • magnesium sulfate, a medication that may exist offered to you lot if your infant is at risk of being built-in very prematurely; this tin can reduce the risk of them developing cognitive 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 data Grouping B Streptococcus (GBS) in pregnancy and newborn babies.

Do I need to stay in infirmary?

Yous volition ordinarily exist brash to stay in hospital for a few days after your waters interruption, to monitor both your and your baby's wellbeing. Your healthcare professional person volition discuss with you the selection of going habitation after this fourth dimension, if you are well and not considered to be at higher risk for giving nascency early.

When should I seek help if I go home?

Before going home from hospital, your healthcare professional volition give y'all information on symptoms to expect out for. Contact your healthcare professional and render to the hospital immediately if you lot feel any of the following:

  • raised temperature
  • influenza-like symptoms (feeling hot and shivery)
  • vaginal haemorrhage
  • if the leaking fluid becomes dark-green or smelly
  • contractions or cramping pain
  • abdominal pain or back pain
  • if yous are worried that the baby is not moving equally normal.

What follow-up should I have?

Y'all should accept regular check-ups with your healthcare professional person (ordinarily one or two times per week).

During these check-ups, your baby'due south heart rate will be monitored, your temperature, pulse and blood pressure will exist checked and y'all volition accept claret tests looking for signs of infection.

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

Experiencing PPROM can be a very stressful time for both yous and your family.

You should be offered emotional support during your pregnancy and later your baby is built-in.

If y'all are worried nigh how yous are feeling, do seek assist from your healthcare professional person and support groups (see links below).

When is the correct fourth dimension to give birth?

If you lot and your baby are both well with no signs of infection and so yous may be advised to wait until 37 weeks to give birth. This is considering carrying on with the pregnancy reduces the chance to your baby that are related to being born preterm.

If you are known to carry the GBS leaner, and so you may be advised to give nativity from 34 weeks because of the risk of GBS infection in your baby. Come across the RCOG patient information Group B Streptococcus (GBS) in pregnancy and newborn babies.

Your healthcare professional should discuss the timing of birth with you depending on your individual circumstances and preferences. You will have the opportunity to ask any questions y'all have about your pregnancy and about preparing for birth.

Volition I be able to have a vaginal nascency afterward PPROM?

It is often possible to take a vaginal nativity after PPROM but this volition depend on when y'all go into labour, the position your baby is lying in in your uterus, and your own individual circumstances and choices.

Your healthcare professional will discuss this with y'all.

How will this affect whatsoever time to come pregnancy?

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

You will be advised to be under the care of a specialist team who volition talk over with y'all a plan 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 have anxiety or who have experienced trauma, physical corruption or sexual corruption, such examinations tin can be very hard.

If yous feel uncomfortable, anxious or distressed at any time before, during or after an exam, delight let your healthcare professional person know.

If you find this hard to talk about, yous may communicate your feelings in writing.

Your healthcare professionals are there to help and they can offer alternative options and support for you.

Remember that y'all tin always ask them to terminate at any time and that you are entitled to ask for a chaperone to exist nowadays. You can likewise bring a friend or relative if you lot wish.

Further information

Piddling Heartbeats: www.trivial-heartbeats.org.uk

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

SANDS: www.sands.org.uk

The United kingdom Sepsis Trust: https://sepsistrust.org

The Birth Trauma Clan: www.birthtraumaassociation.org.uk

Prissy guideline NG25, Preterm Labour and Birth: www.nice.org.united kingdom/guidance/ng25

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

RCOG patient information, Umbilical string prolapse in late pregnancy

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

Shared Conclusion Making

If you lot are asked to make a choice, you may have lots of questions that you want to inquire. Y'all may also desire to discuss your options with your family or friends. It can help to write a list of the questions yous desire answered and take it to your appointment.

Ask 3 Questions

To begin with, endeavour to make certain yous get the answers to 3 key questions, if you lot are asked to make a choice about your healthcare:

  1. What are my options?
  2. What are the pros and cons of each selection for me?
  3. How do I get support to help me brand a decision that is correct 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.u.k./sdm

Sources and acknowledgements

This information has been developed by the RCOG Patient Information Committee. Information technology is based on the RCOG Green-top Guideline No. 73, Care 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 take 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 United kingdom of great britain and northern ireland.

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