Causes of Premature Rupture of Membrane During Pregnancy (PROM)

The amniotic sac, also known as the fetal membrane, is what contains the developing fetus during pregnancy. Rupture of the fetal membrane can occur in four different ways:

  • Spontaneous rupture of membrane (SROM): SROM refers to the naturally-occurring rupture of the fetal membranes during or after the onset of labor. This is a perfectly normal part of pregnancy and requires no additional intervention.
  • Artificial rupture of membrane (AROM): In certain cases, an obstetrician may deem it necessary to induce artificial rupture of the fetal membrane (AROM). AROM is typically induced when any further prolonging of pregnancy can put the baby at risk.
  • Premature rupture of membrane (PROM): PROM is a common complication of pregnancy in which the amniotic sac breaks prior to the onset of labor but at or after 37 weeks of gestation. The causes of premature rupture of membrane vary, though the condition occurs in 8-10% of pregnancies. 1
  • Preterm premature rupture of membrane (pPROM): pPROM refers to any incidence of PROM that occurs prior to 37 weeks. It is a more serious condition which requires immediate intervention to prevent consequences ranging from infection to perinatal death.

Premature Rupture of Membrane: Causes and Risk Factors

There is no single known cause of premature rupture of membranes. Though it is possible for the condition to occur for unknown reasons, certain risk factors have been identified. These include:

  • Poor nutrition or dehydration
  • Smoking during pregnancy
  • An infection in the cervix, uterus or vagina
  • Prior cervical surgery or biopsy

Even though none of these risk factors are necessarily related to chronic conditions, women with a prior incidence of PROM or pPROM are statistically at greater risk of the condition reoccurring in a future pregnancy. 2

Diagnosing PROM

The clearest symptom of PROM is the presence of amniotic fluid pooling in the posterior fornix of the vagina. However, an estimated 47% of PROM cases present no visible symptoms.3 For this reason, accurate testing for PROM, particularly for women at risk, is an important part of prenatal care.

  • Caughey, AB et al. Contemporary Diagnosis and Management of Preterm Premature Rupture of Membranes. Rev. Obstet. Gynecol. 2008;1(1):11–22.
  • Mercer BM. Preterm premature rupture of the membranes. Obstet. Gynecol. 2003 Jan;101(1):178-93.
  • Neil PRL, Wallace EM. Is AmniSure® useful in the management of women with prelabour rupture of the membranes? Australian and New Zealand Journal of Obstetrics and Gynaecology 2010.

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