Rupture of membranes
Under rupture is understood in medicine, the opening of the amniotic sac that surrounds the fetus during pregnancy and by that time, filled with amniotic fluid. The rupture is one of the signs of the beginning of the birth and is usually done spontaneously after the onset of labor.
To facilitate and / or accelerate delivery the amniotic sac can (usually by a midwife ) pierced from the outside, thus opening are ( amniotomy ).
Premature rupture of membranes
From premature rupture of membranes (English: Premature Rupture of Membranes, PROM) is when even before the birth pangs of amniotic fluid going into the amniotic cavity due to a crack.
Premature rupture of membranes is depending on the week of pregnancy a risk to the pregnancy dar. cause of the rupture are common infections in the genital area. A recent study provides the bacterial colonization of the chorion - the outermost layer of the amniotic sac - as a cause of premature rupture of membranes. In 50 % of all pregnancies an early premature rupture within 48 hours leads to the birth. Possible complications from the amniotic fluid loss are ascending infections, depending upon the week of pregnancy training of lung damage or contractures of the extremities as well as a miscarriage or premature birth of the child by induction of labor.
Before the viability of the child (from about the 24th week of pregnancy ) leads premature rupture of membranes usually cause a miscarriage. Before the 20th week of pregnancy, the pregnancy to protect the mother from infection with poor prognosis of the child should be actively terminated.
Between the 22nd and 24th week of pregnancy should be defined individually between a termination of pregnancy or a conservative therapy.
From the 24th to the 28th completed week of pregnancy conservative therapy with Dauerantibiose to avoid infection, perform a lung maturation, as appropriate, undertake a labor inhibition ( tocolysis ) and the least possible impact of the patient should be done. In rare cases ( 7-9 %), the rupture closes spontaneously and the amniotic fluid is formed anew.
From 28 weeks of gestation should be defined individually between the conservative therapy and delivering active. From the 32th week of pregnancy, the children benefit more from a termination of pregnancy by induction of labor or cesarean section.
An alternative, experimental therapy in the early weeks of pregnancy, the amnion patch. Here an attempt is made the hole in the amniotic sac with the help of platelets - these are injected into the uterus - to mend. Especially with bubble jumps after amniocentesis is reported successes. Sometimes the amniotic fluid in the womb is filled in so far as that the child enough amniotic fluid has available to develop optimally. However, this is accompanied by an increased risk of infection.
From early rupture of membranes occurs when the rupture of the membranes after the onset of labor, but takes place before entering the early stage of labor.
More Instantaneous rupture of membranes
Even more transient bubble jumps are known when the amniotic sac ruptures in high areas early and the amniotic fluid then buffed for a certain time. Later it then again to jump the prävialen ( lying in the direction of birth ) bubble shares with renewed amniotic fluid.
Single source evidence
- Obstetrics and Gynecology