29/06/2023
Prelabour rupture of membranes (PROM)- If your waters/membranes break/release at full-term before contractions start, it’s called ‘prelabour rupture of membranes’ (PROM).
Currently in most hospitals if you experience PROM > 24 hours it will be recommended that you submit to an induction of labour. This is because, there is a concern that PROM puts you and your baby at higher chance of complications involving infection.
I’m currently on a deep dive into the research as I’m preparing for another episode of the great birth rebellion podcast and as always, I start my research journey at the Cochrane database of systematic reviews (the tip top best accessible research database there is!)
Their paper ‘planned early birth vs expectant management (waiting) for PROM at term (37 weeks or more)’ found that the 23 studies included in were of low quality stating that ‘the majority of studies contributing data have some serious design limitations, and for most outcomes estimates were imprecise’
This means that after looking at all 23 trials involving 8615 women, that they could not confidently determine the actual chance of infection for women or babies when the two management strategies were compared.
We currently don’t know the most appropriate management options for PROM but your hospital care provider will be recommending induction of labour. So if that isn’t your preference, consider other care options.
Other options I’ve seen offered to women include:
1. Waiting for labour to start (it most likely will in the next 24 hours). don’t put anything in your va**na, don’t accept va**nal examinations or speculum checks, take your temperature every 4-6 hours, monitor the colour of your waters (pink/clear is normal, if it changes to yellow or green, that’s not). Pay attention to the smell of the waters, if it changes and becomes smelly definitely seek help. If you feel unwell then something is not right.
2. Wait for labour to start but accept IV or oral antibiotics also.
