PROM (Premature rupture of Membranes)
PPROM (Preterm Premature rupture of Membranes)

by Angela Westermann

My name is Angela. I am a bereaved mum. My son, Andrew, was bornstill October 22, 2001 due to PPROM.

PROM is a rupture or tear, in the membranes (amniotic sac/water) before labour, at term (37 weeks)
PPROM is a rupture or tear in the membranes before 37 weeks. Known to mums as our water breaking.

From my own experience, I never knew this would even be a cause of worry for me. PROM accounts for many premature births. Statistics on the Internet go as high as 30%. So why may I ask, why am I just now learning about it? Because, before my baby died I was in an abyss of happiness and ignorance, now I am no longer in that abyss. Now I know babies die and I want to know why.

PROM/PPROM is thought largely to be caused by an infection in the uterus or fetal membranes. Why these infections occur is not completely understood. Risk factors include smoking, and some vaginal infections. Also multiple gestations (twins, triplets, etc.) and women who have had PROM/PPROM before.

In the many articles and books I have read, the confusion is, Which came first the infection or the PROM/PPROM? The answer is somewhere in between the two. I even asked my doctor that very question, I got the proverbial answer "We just don't know." My husband and I grilled that doctor for over an hour and a half and it was like a vicious circle. We did not get the answers we had hoped for.

SO my hopes in writing this article, to let everyone know what PROM/PPROM is, what are the symptoms and what if any thing can be done to prevent it.

The main symptom of PROM/PPROM is the breaking of water that may include a sudden gush, or a constant leak of the amniotic fluid. As for myself, I also had an INCREDIBLE amount of pressure. I felt like everything on the inside was going to come out. I thought in my naivete that this was completely normal. And looking back, I remember an increase in my secretions about 2 days prior to this. Increase in secretions may include; thickening, change in colour, change in smell, change in the amount.

PROM/PPROM is diagnosed by several factors. A pelvic exam to determine if the cervix is opened and the membranes have burst or leaking. A drop of the fluid may be obtained to place on a test
strip called Nitrazine paper to determine if the fluid is amniotic fluid. Another test includes looking at the fluid under a microscope. I had both of these tests done, and still it was determined my water
did not break. After I was sent home with the diagnosis of a UTI (Urinary Tract Infection), subsequently to only come back less that 24 hours later fully effaced, with NO hopes of my baby surviving, because he was only 22 ½ weeks gestation. I was told later by my OB that more than likely my membranes had burst. Well hello, that's what I told you in the first place. So was it a misdiagnosis? I don't think so, I think the line between PROM/PPROM and an infection is so closely related it is hard to determine, the true cause.

Once PROM/PPROM has begun the problems arise, preterm birth and infection to the baby and to the mother. Labour almost always follows PROM/PPROM. Some mothers may go on bed rest; most are hospitalized with treatment of antibiotics and monitored for infections. If the baby is before 30 weeks gestation the chance of survival is slim. Because now there is no barrier between bacteria and the baby, monitoring for infections is essential for the mother and the baby.

They say the only controllable factor in PROM/PPROM is smoking. I say, don't tell me that. I say be aware of your body. If ANYTHING does not feel right, get immediately to you doctor. Demand to be
heard. If you have been diagnosed with PROM/PPROM you are at risk for subsequent pregnancies. If you feel, see or hear your water breaking go to your doctor, if the doctor is not open go to the emergency room. If you notice your temperature is up and you feel like you have a fever, get checked out. Some will say we are on the side of being paranoid, I say have your baby die, right in your arms and tell me what would you do?

I am not a doctor by no means, most of this knowledge comes right from the Internet, check it out.
This information is to be used only as a starting reference point. But believe me, the day they laid Andrew in my arms, I cradled him softly against my beating heart as his stopped, MY LIFE CHANGED. The next time I will be asking questions and this time I will get answers.


Author's Note:
Written for Andrew by his mum, Angela

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