Amniotic fluid provides protection of the baby from external
trauma, easy movement, development of the respiratory system, and keeping it at
constant temperature. The membranes around this fluid, namely amniotic
membranes, protect the baby from microorganisms that can pass up through the
vagina and cervix.
Early membrane rupture (EMR); It is the rupture of the
amniotic sac before the birth begins and the waters begin to come. If the
amniotic membrane is torn before the 37th gestational week, it is called
premature EMR (PPROM). It occurs in approximately 10% of all pregnancies.
Prospective mothers speak of a fluid that suddenly drains
from the vagina. However, this fluid discharge may not always be evident and
may occasionally come in a small amount.
Premature membrane rupture is one of the leading causes of
preterm labor.
If more than 18 hours have passed since the water has come
and still birth has not taken place, this condition is called "prolonged
early membrane rupture (prolonged EMR)". The importance of this situation
is that the risk of infection is increased. As the time after the rupture of
the membranes increases, some infectious agents may enter the uterus downwards
and cause the development of chorioamnionitis. Antibiotic prophylaxis is given
to prevent this condition.
Reasons:
In most cases, the cause is unknown (idiopathic). Some
infectious agents (urinary tract or vagina) may play a role. Factors such as
nutritional disorders of the mother, low socioeconomic level, direct traumas to
the abdomen, smoking, cervical insufficiency, excessive stretching of the
uterus (multiple pregnancy or polyhydramnios), placental abnormalities,
amniocentesis, suturing to the cervix (cerclage), uterine anomalies is among
the possible causes of. The risk is also increased in those with a history of
early membrane rupture during previous pregnancies.
Prospective mothers often notice that the membranes are
ruptured suddenly as a fluid drain. In some cases, when there is a rupture of
the membrane from the upper parts of the uterus, there may be slight leaks in
the form of a small amount of urine. Diagnosis is made by the appearance of
fluid leakage from the cervix in the vaginal examination performed in pregnant
women who come with such complaints.
PPROM - EMR
risk factors:
- Low socioeconomic level
- Overstretching of the uterus (multiple pregnancy,
polyhydramnios)
- The mother is extremely weak (Low BMI)
- Malnutrition
- Cigaret
- Surgical procedures applied to the cervix, such as
conization and cerclage.
- Preterm threat of action
- Preterm labor or EMR history in previous pregnancies
- Bacterial vaginosis
Risks
brought by:
One of the most important risks is that EMR is a birth
initiator supplement. Although not always, birth pains begin 24 hours after
most patients arrive. Therefore, the arrival of waters can cause preterm labor.
Preterm delivery will also cause other problems, such as respiratory distress
of the baby.
The second important risk is that the fetus and the lining of
the uterus are open to infection because the membranes protecting it are torn
around the fetus. Infection does not develop most of the time, for this the
mother is closely monitored and necessary antibiotics are prescribed to prevent
it. The infection that results from EMR is called chorioamnionitis. This
infection can pass into the uterus and the blood of the mother candidate from
one side, and cause serious infections in the mother, and on the other hand, it
can pass into the blood of the fetus and the fetus through direct spread and
cause serious infections in the fetus. Pregnancy is terminated when any
infection becomes definite.
In case of very sudden and abundant water, the cord may sag
and the cord may be pinched. This situation is very urgent and can even cause
death of the baby. The detachment may be the placenta after the arrival of
water.
-OVERDUE PREGNANCY
-INTRAUTERINE GROWTH RETARDATION IN PREGNANCY
-BLOOD INCOMPATIBILITY
-CHORIOAMNIONITIS
-STILLBIRTH
