Pre-Term Premature Rupture of Membranes (PPROM) – what is it?

PPROM is the technical term for your waters breaking early, before 37 weeks. Here's everything you need to know, expert advice - plus celebrity mum Jamelia shares what happened when her waters broke at 23 weeks

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If your waters break before your 37th week of pregnancy, you’re experiencing something called PPROM (Preterm Premature Rupture of Membranes).

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In this article, we’ll explain everything you need to know about PPROM, what it means for you, your birth and your baby’s health…

What is PPROM?

PPROM is essentially a medical term to describe what happens when your waters break earlier than 37 weeks.

The ‘premature rupturing of the membranes’ bit quite literally means that the membranes of the sac carrying the amniotic fluid break.

Amniotic fluid or your ‘waters’ then appear, maybe as a little trickle or more of a ‘whoosh’ feeling, or even just dampness, down below.

Further along in your pregnancy, this would be a sign that labour’s due to start soon and your baby’s on the way. Pre-term, that’s obviously the opposite of what you want…

What causes PPROM?

It’s not 100% clear what causes PPROM, if we’re being totally honest. We need some more research on that, please!

It is thought that things like smoking during pregnancy, or experiencing vaginal bleeding throughout pregnancy, may be risk factors.

Having an infection somewhere in your womb or reproductive system can also be a trigger, it’s been suggested.

You may also have a risk of PPROM if you’ve had a premature birth in the past. (Don’t panic, if so – simply have a chat with your GP if you’re worried.)

How do you know if your waters have broken early?

When your waters break, you may experience:

  • damp underwear, or feeling damp down below
  • a gush of fluid coming from your vagina
  • a trickle of fluid coming from your vagina.

If you’ve noticed one of these signs at any stage of pregnancy, you should get yourself to hospital for a check ASAP.

If it is PPROM, you may be going into labour – or docs will need to try and ensure you don’t start labouring anytime soon.

Will you definitely go into labour with PPROM?

Usually, when your waters break, you’ve got anywhere between 12 hours and 24 before labour and contractions get going.

According to Tommy’s charity, around 80% of women who have PPROM deliver their baby within 7 days of their waters breaking.

That said, labour won’t necessarily start just because your waters have broken.

“Waters can break with no sign of labour” explain expert midwife/doula duo Beccy Hands and Alexis Stickland, authors of The Little Book Of Self-Care For New Mums.

“If you do not go into labour, you and the baby do have an increased risk of infection, so you will be asked to go into hospital to be monitored and have your birthing options discussed to decide the safest course of action with your birth team.”

You may also be kept in hospital, given drugs to stop/slow labour, or antibiotics to treat/prevent infection. It depends on your personal situation, so speak to your doc or medical professional to find out more about what care you need.

Sometimes, women with PPROM end up needing to be induced – and if you’re still quite early on in the pregnancy, you may be put on bed rest – like celeb mum-of-3 Jamelia was when her waters broke at 23 weeks.

Celeb mum Jamelia’s PPROM story

jamelia and true

Then 36-year-old Jamelia was enjoying her 3rd pregnancy when her waters broke suddenly, and unexpectedly, at 23 weeks.

“At 23 weeks, I suffered with something called PPROM, which stands for preterm premature rupture of membranes, which basically means that my waters broke early,” she told MFM.

It was a huge shock, not least because her last 2 pregnancies, over a decade earlier, had been pretty smooth sailing. As a result, Jamelia was kept on bed rest to avoid her body going into labour – and keeping her baby inside her for as long as possible.

“They broke at 23 weeks so from that point until the end of the pregnancy I had to stay on bed rest.

“For someone who is totally get up and go, it was so difficult. What I found most difficult was being on bed rest and also worrying for that length of time.

“So, I ended up having True at 35 weeks. And obviously I had to give birth on the weekend where it was like a snowstorm. The trains weren’t running. Ambulances couldn’t get to the house. I had to walk to the train station. And my husband was stuck in London at the time. Honestly, it was carnage.

“And even when I got to the hospital, I was in [prrodromal] labour for 2 weeks, having contractions for 2 weeks. When I got to the hospital, I was 1cm dilated.

“I was 1cm dilated for 3 days, and just as they were about to bring me in for a caesarean – it was like ‘emergency, oh my gosh, the baby’s coming, the head is coming out’ – I was like ‘whaaat?’

“It was crazy and definitely my craziest labour story to date – also my last!”

Can your baby survive if your waters break early?

Absolutely yes, your little one can survive your waters breaking early. The later you are in your pregnancy or the later you deliver, the better the chances are.

Even in the trickiest of situations, our little ones can pull through. Very fortunately, Jamelia’s daughter True Winter was born healthy at 35 weeks, and is now 1 years old.

So, bed rest can help in some cases. Of course, every individual situation is unique.

Beccy and Alexis told us: “If Jamelia’s birth team advised bed rest, this will almost certainly be because they thought this would be best for her and the baby.

“It is widely accepted that bed rest can significantly lengthen pregnancy, which is why this age-old practice continues today.

“It is said that bed rest can slow down leaking of amniotic fluid and reduce the risk of preterm labour. There are many other factors that could have contributed to this decision such as maternal blood pressure and foetal heart rate.”

That said: obviously, there is a risk for mum and baby when waters break early. And the earlier your waters break, there are more risks involved. 

If they break earlier than 23 weeks, it can potentially cause serious damage your baby’s lungs – as unborn babies need the amniotic fluid to help them develop properly. This can be life-threatening for the baby.

So, the best thing you can do is: if you think you’re experiencing the symptoms of PPROM, get yourself to hospital and speak to a medical professional ASAP.

What’s the difference between PROM and PPROM?

You may have heard of waters breaking maybe a week or a couple of weeks early.

That’s what PROM (Premature Rupture of Membranes) is: your waters break after 37 weeks, but still before reaching full term (40 weeks).

“A PROM is a woman’s waters breaking after 37 weeks –  and whilst the likelihood of labour starting is higher than with a PPROM this does depend on the individual medical circumstances,” say Beccy and Alexis.

“A PROM after 37 weeks is however a mild complication and it is usually safe to induce labour if labour doesn’t start naturally.

“Again, in both instances you will be very closely looked after by your birth team and all options of treatment will be looked at to find a plan of action that will keep you and baby safe.”

Share your experience

Did you waters break early? Do you want to share your experience with other mums? Please feel free to share your story in the comments below…

(P.S. Beccy and Alexis’ book for new mums is out now)

Image: Getty Images, MadeForMums / Rekha Damhar

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