• Reference Number: HEY-722/2023
• Departments: Maternity Services
• Last Updated: 1 March 2023

Introduction

This leaflet has been produced to give you general information about your procedure.  Most of your questions should be answered by this leaflet.  It is not intended to replace the discussion between you and your doctor or midwife, but may act as a starting point for discussion.   If after reading it you have any concerns or require further explanation, please discuss this with a member of the healthcare team.

What is a pre labour rupture of membranes?

Pre labour rupture of membranes (PROM) is the term used when your waters have broken prior to your labour starting. This means that the protective sac of fluid around your baby now has a hole in it that is allowing the water to drain away. This draining will continue until your baby is born.

Following assessment of yourself and your baby, you will go home to await the onset of labour. Evidence indicates that 60% of women with pre labour rupture of membranes will go into labour within 24 hours.

It is important that the following advice and guidelines are followed to ensure the safety and wellbeing of both yourself and your baby.

Can there be any complications or risks?

In a very small number of women following rupture of membranes, infection can begin in the fluid surrounding the baby. The risk of serious neonatal infection is 1% rather than 0.5% for women with intact membranes.

However, research shows that there is no greater risk to you or your baby if you go home rather than stay in hospital to wait for your labour to start.

Advice to follow at home

You will need to check your temperature at home every 4 hours whilst awake.

General hygiene is important to prevent infection

Change your sanitary pad frequently, at least every four hours during the day (whether it is wet or not).

Do not use tampons.

You can bathe and shower as normal but do not use bubble bath or bath oils.

Do not go swimming.

Do not use any deodorant, talc or perfumes around the genital area.

Refrain from any form of sex as this may be a source of infection.

You should contact the hospital for advice if you are concerned in any way about your pregnancy or your baby or you experience any of the following:

• Feeling unwell, hot or feverish or if the temperature you are taking goes above 37.5ºC.
• The colour of the waters you are draining changes: becomes cloudy, brown, green or blood stained.
• The waters you are draining become smelly.
• The pattern of your baby’s movements changes significantly.
• Contractions or tightenings you may experience become increasingly stronger.
• If you have any other worries or concerns about your well-being.

General hygiene is important to prevent infection

• Change your sanitary pad frequently, at least every four hours during the day (whether it is wet or not).
• Do not use tampons.
• You can bathe and shower as normal but do not use bubble bath or bath oils.
• Do not go swimming.
• Do not use any deodorant, talc or perfumes around the genital area.
• Refrain from any form of sex as this may be a source of infection.

What will happen if spontaneous labour starts?

If you go into labour within 24 hours  and there are no signs of infection, you can continue with your plan to deliver on a midwife led unit, if that is where you have been booked to have your baby.

What will happen if I do not go into labour?

If your labour does not start by itself, we recommend inducing your labour (starting you off). You will be given an appointment at the Women & Children’s Hospital in the induction of labour clinic after 24 hours, for an antenatal check and a cardiotocograph electronic monitoring of your baby’s heartbeat (CTG). You may be admitted to Maple Ward (the antenatal ward) to await induction of labour on the Labour Ward if there are any concerns.

If you choose to wait longer than 24 hours, or there is a delay in arranging a bed on the Labour Ward, it is important that we check both you and your baby on a daily basis. You will be asked to come to the hospital for an antenatal check and a cardiotocograph electronic monitoring of your baby’s heartbeat (CTG). This is to make sure that you and your baby are healthy.

What if I tested positive to Group B streptococcus (Group B Strep or GBS)?

This would be a reason to advise induction of labour as soon as possible, with antibiotics in labour.

What happens afterwards?

After your baby is born, if your membranes were ruptured for more than 18 hours, we recommend that you stay in the hospital for at least 12 hours after birth to make sure your baby shows no signs of infection.

General Advice and Consent

Most of your questions should have been answered by this leaflet, but remember that this is only a starting point for discussion with the healthcare team.

Consent to treatment

Before any doctor, nurse or therapist examines or treats you, they must seek your consent or permission. In order to make a decision, you need to have information from health professionals about the treatment or investigation which is being offered to you. You should always ask them more questions if you do not understand or if you want more information.

The information you receive should be about your condition, the alternatives available to you, and whether it carries risks as well as the benefits. What is important is that your consent is genuine or valid. That means:

• you must be able to give your consent
• you must be given enough information to enable you to make a decision
• you must be acting under your own free will and not under the strong influence of another person

Information about you

We collect and use your information to provide you with care and treatment. As part of your care, information about you will be shared between members of a healthcare team, some of whom you may not meet. Your information may also be used to help train staff, to check the quality of our care, to manage and plan the health service, and to help with research. Wherever possible we use anonymous data.

We may pass on relevant information to other health organisations that provide you with care. All information is treated as strictly confidential and is not given to anyone who does not need it. If you have any concerns please ask your doctor, or the person caring for you.

Under the General Data Protection Regulation and the Data Protection Act 2018 we are responsible for maintaining the confidentiality of any information we hold about you. For further information visit the following page: Confidential Information about You.

If you or your carer needs information about your health and wellbeing and about your care and treatment in a different format, such as large print, braille or audio, due to disability, impairment or sensory loss, please advise a member of staff and this can be arranged.

Your newborn baby’s NHS number

An NHS number is allocated to everyone whose birth is registered with a Registrar of Births and Deaths in England and Wales. You already have an NHS number and your baby will be assigned an NHS number soon after birth. Your NHS number is unique to you and provides a reliable means of linking you to the medical and administrative information we hold about you. NHS numbers are allocated on a random basis and, in themselves, provide no information about the people to whom they relate.