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When she was 33 weeks pregnant, first-time expectant mum Chan Huijun 32, suddenly felt a gush of water in her underwear. She thought she had peed.<\/p>\n
\u201cI had just gone for yoga, and I was walking around the mall nearby. I was conscious about my pants being stained, so I quickly hopped into a cab and headed home,\u201d she recalls.<\/p>\n
She didn\u2019t think that it would be her water bag leaking, because she was still some two months away from her due date.<\/p>\n
When she arrived home, the gushing seemed to stop, although she noticed that her underwear seemed to be constantly damp over the next few hours. When Chan called her husband, the couple decided to go to the gynae for a check, just in case.<\/p>\n
However, when she felt several \u201csmall gushes\u201d on her way to the clinic, it occurred to Chan that her amniotic fluid might be leaking. \u201cNothing hurt, but I was so worried about moving making sudden movements. I kept trying to hold it in, but it was impossible.\u201d<\/p>\n
At the clinic, her gynae confirmed that Chan\u2019s water bag was leaking and placed her on hospital bed rest.<\/p>\n
With constant monitoring, Chan delivered a healthy baby girl at 35 weeks.<\/p>\n
\u201cI was so worried about moving or making sudden movements. I kept trying to hold it in, but it was impossible.\u201d<\/p>\n
Preterm Premature Rupture of Membranes (PPROM)<\/p>\n
The membranes of the amniotic sac rupturing before 37 weeks of pregnancy, which causes the amniotic fluid to leak, is known as PPROM. The condition happens in some 2 per cent of pregnancies.<\/p>\n
Dr Liana Koe, an obstetrician and gynaecologist at Thomson Medical, says that it could feel like a gush of fluid from the vagina, or just a trickle of water. \u201cYou will likely feel fluid leaking thereafter. The fluid is usually clear in colour, but can be mixed with red or pink discharge.\u201d<\/p>\n
In addition, if the baby is distressed, it may pass motion in the womb, resulting in green or brown amniotic fluid. \u201cIn this case, immediate attention is needed,\u201d Dr Koe warns.<\/p>\n
What causes PPROM?<\/strong><\/p>\n Thomson Medical obstetrician and gynaecologist Dr Freda Khoo explains that a common cause is an infection in the genital tract, \u201cThe infection weakens the integrity of the membranes, causing a leak prematurely.\u201d<\/p>\n Other causes include recurrent bleeding in pregnancy, a weak cervix and smoking. \u201cIn the case of a weak cervix, for example, if the expectant mum has had a previous surgery done on the cervix before, the weakened cervix may fail to act as a barrier to the ascending infections from the external environment,\u201d Dr Khoo explains.<\/p>\n Other factors that increase the chances of PPROM include a previous history of preterm birth, or multiple pregnancies, says Dr Koe. \u201cAn extremely high amniotic water level may also stretch the womb, increasing the risk of PPROM,\u201d she adds.<\/p>\n Does PPROM pose a danger?<\/strong><\/p>\n PPROM can vary in danger and severity. For instance, if there is only a small \u201chole\u201d in the membrane, it may quickly seal up, Dr Khoo notes. But if it doesn\u2019t, it means that the foetus in the uterus is exposed to the external environment, and thus potential infections, she explains. \u201cThere is a risk of infection of the amniotic fluid and membranes, which may lead to the infection of the foetus and even in the pregnant mum\u201d.<\/p>\n Dr Koe lists the four main dangers of PPROM:<\/p>\n a) Early labour<\/span><\/p>\n The early rupture of membranes can trigger labour pains, resulting in early delivery. How dangerous this is depends on the baby\u2019s gestation period \u2015 which impacts whether it would have breathing difficulties that require supportive care, infections, or damage to their brain. \u201cThe younger they are, the more serious the implications,\u201d Dr Koe points out.<\/p>\n b) Infection affecting the baby and mother<\/span><\/p>\n If delivery doesn\u2019t happen, both the mum and baby are at risk of infection. The doctor has to balance the risk of infection against the risk of early delivery. If there are signs of infection, delivery is usually required to reduce the risk of complications.<\/p>\n The aim of PPROM treatment is to prevent and detect infection, while prolonging the pregnancy as much as possible.<\/p>\n c) Low amniotic fluid levels<\/span><\/p>\n If the waters have broken, the fluid level will usually be lower. Since these waters are required for the baby\u2019s lung development (especially before 23 weeks), it may affect the development of their lungs, giving rise to severe problems after birth.<\/p>\n After 24 weeks, low fluid levels may not affect lung development as much. However, the reduced space for the baby to move around means that the umbilical cord may be compressed, which can affect the baby\u2019s heartbeat.<\/p>\n d) Cord prolapse<\/span><\/p>\n When the amniotic sac breaks, the baby\u2019s umbilical cord may fall through the cervix \u2015 known as cord prolapse. \u201cThis can affect the baby\u2019s heartbeat suddenly, which is an emergency situation that requires immediate delivery,\u201d Dr Koe explains.<\/p>\n How PROM is treated<\/strong><\/p>\n If you suspect that you have PPROM, see your doctor immediately. Your doctor can assess and perform tests to confirm if the amniotic sac has indeed been ruptured, Dr Khoo says.<\/p>\n Dr Koe explains that PPROM treatment aims to prevent and detect infection, while prolonging the pregnancy as much as possible.<\/p>\n \u201cAntibiotics are given to reduce infection risks,\u201d she says. \u201cDuring this time, mother and baby will be monitored \u2015 this includes the mother\u2019s heart rate, blood pressure, and temperature.\u201d<\/p>\n The doctor will also look for other signs like abdominal pain or contractions, and foul-smelling discharge. Urgent delivery may be advised if there is a sign of infection.<\/p>\n If the baby is at a risk of coming too early, the doctor can do several things, she notes. These include:<\/p>\n![\"\"](\"https:\/\/stogpractice.com\/staging\/wp-content\/uploads\/2023\/07\/Pregnancy-What-happens-if-my-waters-break-before-labour-2.jpeg\")
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