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Premature Rupture of Membranes at Term

  • Cynthia M. Johnson, MA
Publication Type:


Premature Rupture of Membranes at Term



Premature rupture of membranes (PROM) at term is when the amniotic sac breaks before labor begins. The sac holds amniotic fluid and the growing baby. With PROM, the amniotic fluid inside the sac leaks or gushes out of the vagina. This is also known as water breaking.

Fetus in the Amniotic Sac.

BL00030_96472_1http://services.epnet.com/getimage.aspx?imageiid=61856185BL00030_96472_1.jpegFetus in Utero_2NULLjpegBL00030_96472_1NULL\\hgfiler01a\intellect\images\BL00030_96472_1.jpegNULL148NULL2006-01-115403946185_598937Copyright © Nucleus Medical Media, Inc.


PROM at term is caused by membranes that are weak or thin.

Risk Factors

Things that may raise the risk of PROM at term are:

  • Being pregnant for the first time
  • PROM in earlier pregnancies
  • Premature contractions
  • First trimester bleeding
  • Chlamydia
  • Low body mass index


The main symptom of PROM is fluid leaking from the birth canal. There may be a sudden gush or a slow trickle.

PROM raises the risk of infection. There may also be:

  • Fever
  • Rapid heartbeat

Complications from PROM may be:

  • Fetal infection
  • Uterine infection
  • A placenta that separates from the uterus before the baby is delivered— placental abruption
  • An umbilical cord that is squeezed between the baby and the pelvis— prolapsed umbilical cord


If a large amount of fluid is leaking from the birth canal, PROM is likely.

It can be hard to tell a slow amniotic trickle apart from urine. These tests may be done:

  • Nitrazine paper test—the doctor puts a small amount of fluid on a piece of paper to see if the fluid that is leaking is amniotic fluid
  • Microscopic exam of the fluid


Labor usually begins within hours after PROM. If labor does not begin, medicine may be given to start it.

The mother and baby will be watched closely to look for signs of any problems.


There are no current guidelines to prevent PROM.





  • American College of Obstetricians and Gynecologists (ACOG) Committee on Practice Bulletins-Obstetrics. Practice Bulletin Number 217: Prelabor Rupture of Membranes Obstet Gynecol. 2020 Mar;135(3):e80-e97.
  • Placental abruption. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/placental-abruption.
  • Prelabor rupture of membranes. The American College of Obstetricians and Gynecologists website. Available at: https://www.acog.org/clinical/clinical-guidance/practice-bulletin/articles/2020/03/prelabor-rupture-of-membranes.
  • Premature rupture of membranes at term (term PROM). EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/premature-rupture-of-membranes-at-term-term-prom.


  • Beverly Siegal, MD, FACOG
Last Updated:

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.