Understanding Risks When Your Water Breaks During Labor

Rupture of membranes (ROM) at term is usually benign; preterm ROM (PROM) carries risks.

Term PROM (≥37 weeks)

• Labor usually starts within 24h.
• Induction vs. expectant management discussion.
• Infection risk increases with duration (>18–24h).

Preterm PROM (<37 weeks)

• Neonatal risks: RDS, sepsis, IVH, NEC.
• Maternal risks: chorioamnionitis, abruption.
• Management: corticosteroids (lung maturity), antibiotics (latency), magnesium sulfate (neuroprotection <32w), tocolytics (short-term), delivery timing by gestational age.

Specific Risks

• Cord prolapse: Emergency; presents with variable decelerations. Relieve pressure, deliver ASAP.
• Infection: Maternal fever, tachycardia, uterine tenderness, fetal tachycardia.
• Malpresentation: Breech/transverse more likely with less fluid.

When to Call Provider

• Fluid gush or trickle (note color, odor, time).
• Fever, foul discharge, decreased fetal movement.
• Any concern.

Most babies do well; timely management optimizes outcomes.