Waters breaking early (PPROM)

If your waters break early, seek medical advice straight away as you could be at risk of premature labour.

PPROM infographic

Your unborn baby lies in an amniotic sac of fluid or ‘waters’. ‘Waters breaking’ means that the sac has ruptured or broken. Your waters normally break around the time labour is due but in around 2% of pregnancies they break early for various reasons (see below).

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 (PPROM)?

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 are the risks if my waters break early (PPROM)?

If your waters break early the risks and treatment are dependent on the stage of pregnancy you are at.

  • You are at risk of going into labour prematurely – the health risks for the baby of early birth are greater the younger they are.
  • If you do not go into labour, you and the baby are at risk of infection because the normally sterile waters have been broken.

The doctors have to balance these two considerations. If the waters have broken because of infection, you and the baby have a high risk of getting the infection and you may need to deliver sooner to prevent this.

If the waters have broken but there is no infection currently present, you and the baby are still at risk but the immediate risk is lesser and your treatment will depend on your stage of pregnancy.

If you are under 24 weeks of pregnancy and the baby is born, sadly, it is unlikely the baby will survive.

If you are over 30 weeks and the baby is born, the likelihood of your baby surviving is very high - over 95%

What will happen if my waters break early (PPROM)?

Over 80% of women who have PPROM deliver their baby within seven days of their waters breaking.

If you don't go into labour, you may leak fluid for the rest of your pregnancy. However, you and the baby are at high risk of infection and you could suddenly go into labour.

If you are past 34 weeks the doctor will weigh up the benefits of inducing delivery before the due date to avoid the risk of infection with the disadvantages of being born premature, and may make a recommendation for early delivery.

You may need to stay in a hospital that has 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.

What if there are no waters left in my womb?

Your baby’s amniotic sac has to have the right amount of amniotic fluid for the pregnancy to continue normally. If there is a break in the waters your baby will continue to produce amniotic fluid.

Before 23 weeks, the baby needs ‘waters’ to be present for their lungs to develop normally. Loss of water before this can lead to severe problems with lung development that can be critical after birth. After 23 weeks your baby does not need the amniotic fluid so much, so low levels of fluid may not be a problem in itself, but if the low levels are due to your waters breaking then there is a risk of infection.

Read more about intrauterine infection and chorioamnionitis

Causes of waters breaking early (PPROM)

Intrauterine infection is present in around a third of women with PPROM. Although there is clear evidence that infection travelling from the vagina is linked to PPROM, many cases happen without any infection being present. The reason for these cases is unclear, however it has been linked to heavy smoking (more than 10 cigarettes a day) in pregnancy

Read more about delivering an early baby

Read more

  • Discharge in pregnancy

    Discharge in pregnancy

    A slight increase in discharge/fluid during pregnancy is normal, especially when the weather is hot. You may find that it is a mild-smelling, milky fluid, which is fine.

Sources

  1. RCOG (2012) Information for you When your waters break early, Royal College of Obstetricians and Gynaecologists
  2. J David, Steer P et al (2010) High risk pregnancy, management options, Elsevier Saunders
  3. RCOG (2006) Preterm Prelabour Rupture of Membranes, Greentop guideline 44, Royal College of Obstetricians and Gynaecologists
  4. England MC, Benjamin A, Abenhaim HA (2013) Increased Risk of Preterm Premature Rupture of Membranes at Early Gestational Ages among Maternal Cigarette Smokers. Am J Perinatol. 2013 Jan 17 
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Last reviewed on June 1st, 2014. Next review date June 1st, 2017.

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Comments

  • By Midwife @Tommys on 25 Aug 2016 - 15:54

    It sounds as if you are having the perfect management at your hospital for you and your baby.
    Being given steroid injection to mature your baby's lungs and being given iv antibiotics is the correct management for you and baby at this time. Good luck with everything :) They will take good care of you both. Just listen to their plan of care for you and ask them plenty of questions. It can be scary, but it is less scary when you have all of the information - when you have had all of your questions answered.

  • By Midwife @Tommys on 25 Aug 2016 - 15:47

    If your waters break after 37/40 gestation this can be a normal feature of early labour. A term baby is one which is 37 weeks gestation and over.
    Most hospitals differ slightly in their guidance about how long to leave a lady to naturally go into labour after their waters have broken. However most of time it ranges between 12-24 hrs. After this time, you would be strongly recommended to come into the labour ward to have your labour augmented - where you would be put on a hormone drip to start giving you contractions and to start labour off. Your baby would have continuous monitoring if augmentation of labour was chosen. Your midwife and Obstetric team would go through everything in detail with you before this too.

  • By Anonymous (not verified) on 25 Aug 2016 - 14:18

    2days before at night 2'o clock i was lying at bed and suddendly felt a gush of water wtting my paint and matress on bed....aftr tht i felt watr evry half and my paints get wet....the next da i visit my dctr and she told tht my amniotic sax has broken...fron thn i am at hsptl now getting injection for the baby's lungs and anfibiotics to avoid infectuon...dctr says u hv nt much watd loss sufficent fluid is present inside for the baby...so v try to wait till u entr ur 36 weeks...bt i am too much scared

  • By Anonymous (not verified) on 25 Aug 2016 - 12:43

    hello.
    if the water breaks after 37 wks, what is the best management to do?
    what is the effect of it to the unborn child? is it normal that when BOW breaks b4 labor it it will affects the contractions?

  • By Midwife @Tommys on 19 Aug 2016 - 15:32

    Hi, I am very sorry but I am not sure I understand your question, if the information above does not answer your query please do email a midwife at midwife@tommys.org or you can call us on 0800 0147 800.

  • By Anonymous (not verified) on 19 Aug 2016 - 15:24

    mery uterus weak hai mjy shirodkar sti????ch lga hua tha bt 8th month m mera water break ho gaea aor premature baby boy hua bt 2nd day os ki death ho gae.kia water break ka koi ilaj nai hai k pregnency ful term posible ho sky????

  • By Midwife @Tommys on 29 Jul 2016 - 15:28

    If you think your waters may have broken it is really important that you go straight to your maternity unit to be reviewed. Please do not put off going in, you can take someone with you to support you. Please also know we are here too if you need some support on 0800 0147 800 or midwife@tommys.org

  • By Midwife @Tommys on 29 Jul 2016 - 15:25

    Sorry to hear you are having such an eventful pregnancy. Rest up and if you would like to speak to a midwife please do get in contact either call on 0800 0147 800 or midwife@tommys.org

  • By Anonymous (not verified) on 29 Jul 2016 - 05:50

    So on July 1st 2016 I noticed some fluid it had gushed out I sat down for 30 minutes and stood back up and it gushed again. I called the hospital and was told to come.in immediately, well when they called.my doctor he did some exams on me.and found out the sac had a tear in it, im 25 eeeks and 2 days now and in complete bedrest until my due date . When I went back to obgyn they said that they were going g to send me to Huntsville AL to get a second opinion on whether I should deliever or stay in bed rest
    .... Right now the fluid still come out but it comes then goes. Hoping for a safe delivery!!!

  • By Anonymous (not verified) on 28 Jul 2016 - 20:38

    I think my water just break as we speak. I feel wet in my panty, and water just run out of my vigina so what can I do I'm scared of loosing my baby.

  • By Deirdre@Tommy's on 19 Jul 2016 - 10:43

    Losing a baby is devastating whatever the gestation, so you have to come to terms with the loss emotionally as well as physically. The natural instinct is to get pregnant again as soon as possible and there is no problem with this, but allow yourself some time to recover too. Regarding how long to wait before trying to get pregnant after a loss, it is usually advised to wait to have your next period first as there is often some bleeding & period like pains following a 20 week loss, so best to let that settle down first. Please feel free to contact one of our Tommy’s Midwives for a chat on 0800 0147 9800 to help you talk through your concerns at this difficult time.

  • By Anonymous (not verified) on 8 Jul 2016 - 15:12

    I hope everything worked out for you...

  • By Anonymous (not verified) on 8 Jul 2016 - 06:54

    Hi I recently lost my baby at 20 weeks due to pprom the dr. Said his lungs weren't developed yet so I was wondering how long do I have to wait before trying to get pregnant again?

  • By Deirdre@Tommy's on 7 Jul 2016 - 10:49

    Hi,
    Your situation sounds very worrying. We can't discuss or advise here without knowing more though. Please call us on 0800 0147 800 to talk. We're on the line 9-5 Mon to Fri.
    Tommy's Midwives

  • By Anonymous (not verified) on 3 Jul 2016 - 19:53

    My water broke at 25 weeks and had labour pains,the doctors wer able to stop the pains but was put on total bedrest,i was give antiboitic shots and shots for babys lungs,was told no water was left there,the baby is still playing but am bleeding like its periods i keep changing pads,im so worried on whats happening.doctor told me the baby might be delivered in 2 or three days but whats worrying me is the bleeding

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