If your water breaks before the 37th week of pregnancy, it's known as preterm prelabor rupture of membranes. This is sometimes called preterm PROM. Your water breaking too early might have no known cause. But the following can increase the risk:
- Having had preterm prelabor rupture of membranes in an earlier pregnancy.
- Swelling and irritation, called inflammation, of the fetal membranes. This is called intra-amniotic infection.
- Vaginal bleeding during the second and third trimesters.
- Smoking or using illicit drugs during pregnancy.
- Being underweight with poor nutrition.
- A shortened cervix. The cervix is the lower end of the uterus that connects to the vagina.
Health issues that can be caused by preterm prelabor rupture of membranes include:
- Infection for you or the baby.
- The placenta peeling away from the inner wall of the uterus before delivery. This is called placental abruption.
- Problems with the umbilical cord.
Premature birth also puts the baby at risk of other health concerns.
If you have preterm prelabor rupture of membranes and you're at least 34 weeks pregnant, your healthcare team might suggest delivery to keep you or the baby from getting an infection. If there are no signs of infection or other concerns about the baby, though, research suggests that pregnancy can go on safely for a time. But it's likely that your healthcare team will need to watch you and the baby closely in the hospital. This is called watchful waiting.
If you're between 24 and 34 weeks pregnant, your healthcare team likely will try to delay delivery until your baby has more time to grow. Antibiotics can help prevent an infection and shots of steroid can speed your baby's lung growth. If you're less than 32 weeks pregnant and at risk of delivering within a few days, you might get magnesium sulfate to protect the baby's nervous system.
Starting at week 23 of pregnancy, your healthcare team might suggest steroids if you're at risk of delivering within seven days. This also is true if you're between weeks 34 and 36 and six days of pregnancy, at risk of delivering within seven days, and you haven't had steroids already. You might get steroids again if you're less than 34 weeks pregnant, at risk of delivering within seven days and you had the first steroids more than 14 days before.
If you're less than 24 weeks pregnant, your healthcare team talks with you about the risks of having a baby that early and the risks of trying to delay labor.