When a pregnant woman’s water breaks, it means the amniotic sac that surrounds the baby has broken or torn. This is called the rupture of membranes. Typically the membranes rupture during or just prior to the start of labor. If the membranes rupture when the mother is beyond 37 weeks of gestation and labor has not yet commenced, it is called a premature rupture of membranes (PROM). If membranes rupture prior to 37 weeks, it is called a preterm, premature rupture of membranes (P-PROM).
The Ohio PROM and P-PROM attorneys at The Becker Law Firm have obtained millions of dollars in verdicts and settlements in cases involving medical negligence associated with PROM and P-PROM.
Rupture of Membranes: Injuries Caused By Improper Management
The failure to establish whether PROM or P-PROM have occurred and/or failure to properly respond to a premature rupture of membranes can put the baby at risk of serious birth injuries. Bacteria and other germs in the vagina can gain direct access to the fetus. The umbilical cord can prolapse. The membranes can become inflamed. P-PROM can bring on preterm labor, exposing the child to the risks of premature birth, including respiratory distress or brain damage from lack of oxygen (hypoxia, asphyxia) due to lungs that are ill-formed.
There are many complications that can result from improper management of rupture of membranes at all stages. Some of the most common are:
- Respiratory distress syndrome
- Neonatal sepsis
- Umbilical cord prolapse
- Placental abruption
- Wrongful death of the baby
Medical Treatment for PROM and P-PROM
Treatment depends on the age of the baby. The two factors that the doctor must weigh are the risks of prematurity versus the risks of infection. Typically, before 32 weeks the baby will benefit from more time in the womb; after 36 weeks the baby should be delivered; and from 32 to 36 weeks, this can be a more complicated decision, dependent on the developmental stage of the baby.
Rupture of membranes before 37 weeks can cause preterm labor and delivery and chorioamnionitis (an infection that can cause cerebral palsy). Untreated, 50% of patients will go into labor within 24 hours, and 75% will go into labor within 48 hours. Even though more time in the womb is important for continued development, PPROM may increase the risk of chorioamnionitis, placental abruption, and cord prolapse.
To determine whether preterm rupture of membranes has occurred, the physician should talk with the expectant mother and possibly perform additional testing. If those tests are inconclusive, an ultrasound may show the level of amniotic fluid to determine if a rupture has occurred.
When chorioamnionitis is a concern, the mother’s temperature and white blood count should be closely tracked, the mother should be evaluated for uterine tenderness, and the fetal heart rate tracings should be monitored closely.
Antibiotics like ampicillin can help to prevent the period before labor. P-PROM occurs in three percent of pregnancies and causes one-third of all preterm deliveries.
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