Last updated September 2011. Planned review date: September 2013

Waters breaking early (PPROM) and premature birth
If your waters break early don't panic, but do seek medical advice straight away as you could be at risk of premature labour.
The membranes that make up the sac that holds your baby usually break at the start of labour (referred to as 'waters breaking').
If your waters break before your baby has reached full term, the medical name for it is preterm premature rupture of the membranes, or PPROM. If this happens early, before the contractions start, it can (but does not always) trigger early labour.
Have my waters have broken early?
If your waters have broken early, you will experience it as a trickle or a gush of water from your vagina. If it isn't too heavy you can use a sanitary towel to catch it. This will also allow you to see what colour it is. It may be pinkish if it contains some blood, or it may be clear. If it is heavy, you may need to use a towel.
What should I do if my waters break early?
Phone the hospital for advice immediately. The break can't be repaired, but your baby's kidneys will keep producing amniotic fluid. After 23 weeks your baby does not need the amniotic fluid to be able to develop normally.
If you don't go into labour the sac may retain some fluid, but you may leak fluid for the rest of your pregnancy. However, you will be at high risk of infection and could suddenly go into labour.
You may need to stay in hospital in a neonatal unit, and be monitored carefully for any sign of infection. You may also be treated with antibiotics and corticosteroids, to help prepare your baby's lungs in case he is born prematurely.

For most women, the cause of PPROM is unclear, however it has been linked to:
The amniotic fluid
The amniotic sac containing your baby needs to have the right amount of amniotic fluid for the pregnancy to continue normally. Oligohydramnios is a condition associated with low leves of amniotic fluid in the womb.
After 23 weeks this is not a problem in itself, but if the low levels are due to PPROM then there is a risk of infection.
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Explaining premature birth:
Your premature baby:
You can also read about
Sources
RCOG (2008) When your waters break early (preterm prelabour rupture of membranes) - information for you, Royal College of Obstetricians and Gynaecologists
RCOG (2006, reviewed 2010) Preterm Prelabour Rupture of Membranes, Royal College of Obstetricians and Gynaecologists, p2
Mercer B, Milluzzi C, Collin M (2005) Periviable birth at 20 to 26 weeks of gestation: proximate causes,previous obstetric history and recurrence risk, American Journal of Obstetrics and Gynecology, Vol 193, No 3, Pt 2, pp 1175-80
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