Premature rupture of the membranes, should you have a caesarean section?

Premature rupture of membranes (PROM) is a condition where the amniotic sac ruptures too quickly, when the gestational age is not yet 37 weeks. The amniotic sac is fairly normal if broken moment or after labor begins. Premature rupture of the membranes can cause the mother to give birth to a baby prematurely. So, do you have to have a caesarean if your membranes break prematurely?

Identify the dangers of KPD

PROM increases the risk of chorioamnionitis (infection of the amniotic fluid) by 70 percent. This is because the amniotic fluid has broken so that the access of bacteria to the amniotic fluid will be easier.

Chorioamnionitis is very dangerous, both for the mother and the fetus. It should also be borne in mind that the longer the PROM occurs, the greater the risk for the mother to experience chorioamnionitis.

Symptoms include fever (more than 37.5 degrees Celsius), abdominal pain, abnormal vaginal discharge, very fast heart rate (more than 100 beats per minute), the baby's heart rate is very fast (more than 160 beats per minute) and the presence of increased levels of leukocytes.

This infection can cause death, both for the mother and the baby. Babies born to mothers with this infection also have a higher risk of developing sepsis and pneumonia (pneumonia).

Is it true that premature rupture of the membranes should always be cesarean section?

If KP has been going on for a long time (more than 12-24 hours) and the gestational age is over 34 weeks, it is recommended to go into labor immediately. Most doctors will advise pregnant women to have a cesarean section if the water breaks too quickly. This is because it is not time for a normal vaginal delivery.

However, if the gestational age is very early (for example, less than 34 weeks), it is feared that your baby's lungs are not yet mature. So, the mother may be given antibiotics, such as ampicillin and erythromycin. This antibiotic is useful to help reduce the risk of infection so that it is hoped that the delivery process can be waited until the fetal lungs are mature.

In addition, therapy can also be given which functions to help the maturation of the baby's lungs, such as giving corticosteroids (for example dexamethasone). Corticosteroids will trigger the production of surfactants which are very important in lung development.

Does premature rupture of membranes mean you have to go into labor right away?

No, because it turns out that only 50 percent of women who experience premature rupture of membranes will give birth spontaneously within the next 12 hours. Meanwhile, as many as 95 percent will give birth within the next 72 hours.

How do you know if it is amniotic fluid?

To make sure whether the amniotic fluid is true or not, the litmus paper method can be used. Litmus paper will change when exposed to a liquid with an alkaline pH. Paper that is initially red will turn blue when it is exposed to amniotic fluid (alkaline pH). Vaginal fluid will have a pH of 4.5-5.5 while amniotic fluid will have a more alkaline pH of 7.0-7.5.

You can also do a check using inspekulo (a tool that is inserted into the vagina and is shown to see the inside of the vagina). By using inspekulo, you will see a discharge from the vagina.

Can PROM be prevented?

The decrease in collagen levels that cause PROM can actually occur due to many factors. There are even KPDs that are idiopathic (the cause is unknown). However, there is nothing wrong with adopting a healthy lifestyle and maintaining health during pregnancy.

Keep your female area clean, drink adequate amounts of water, and don't get in the habit of holding back bowel movements or urinating too often. You should also routinely have your womb checked by a doctor.