PREMATURE RUPTURE OF FETAL MEMBRANES

Premature rupture of membranes and loss of amniotic fluid per vagina rarely (<20% of cases) results in amniotic fluid pockets of less than 2cm.

The presence of amniotic fluid after membrane rupture is explained by:

1. The fetus continues to produce amniotic fluid.
2. The presenting part in the lower uterine segment may have an occlusive effect.
3. The effect of gravity in which the amniotic fluid collects in portions of the uterus that is lower than the internal os is the supine position. Moving the patient from the supine to erect state after premature rupture of membranes results in a gush of fluid, which gradually ceases on returning to the supine position.

COMPLICATIONS (1)

• Increased risk of infection.
• Increased risk of uterine crush syndrome in the immature fetus.
• Increased risk of premature delivery and its associated complications

REFERENCES

1. Nimrod C, Varela-Gittings F, Machin G et.al. The effect of very long membrane rupture on fetal development. Am J Obstet Gynecol 1984;148:540.