Following preterm pre-labor membrane rupture, for the mother, the feared complication
is infection, a condition called "chorioamnionitis". It simply means "inflammation
of the membranes".
This is a potentially serious problem and can even lead to septicemia (infection
of the blood). This is estimated to affect up to a third of all pregnancies with
prolonged rupture of membranes, the vast majority of cases being only mild and treated
in time. The role of antibiotics is discussed below.
Preterm rupture of membranes also increases the chance of a caesarean delivery.
We should not forget that this complication of pregnancy is managed wholly in hospital
and the prolonged hospitalization, sometimes lasting several weeks, could be severely
Preterm rupture of membranes: The baby
Effect on the baby depends on the degree of prematurity. Again, remember, once the
‘waters’ break, delivery will occur within a week in 80% of cases. If the rupture
occurs as early as around 24 weeks, one is facing a specter of delivering a tiny
baby with hardly any lung development. The outlook is then very poor indeed. This
is so unless the pregnancy can be prolonged for several weeks. Even when this is
achieved, it is not all light and sunshine. These babies face multiple problems as
a result of developing in the womb where there is little or no water.
If the rupture occurred very early, lung development - which is dependent on the
presence of adequate fluid - will be severely impaired. This may prove to be a difficult
problem to overcome even after delivery- and the baby may face a battle to survive.
Other problems caused by lack of fluid in the womb include limb deformities. These
are positional and correctable.
There may also be facial deformities (usually mild) and growth restriction. In any
case of prolonged rupture of membranes, there is the ever-present risk of infection,
which will normally force delivery. Once infection is detected, there is no option
but to deliver the baby.
Dealing with poor fetal lung development
If the membranes rupture relatively late - let's say after 28 weeks - the lung development
problem is either mild or does not occur. If it is as early as 22 to 24 weeks, it
is potentially very serious.
One management strategy which is not quite established in mainstream practice and
whose value has yet to be fully established is the so-called ‘ammo-infusion’. In
this, sterile fluid is infused into the womb every few days to try to create a "normal"
environment for the fetus. Results so far have been variable.