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When the fetus is 34 to 37 weeks gestation, the risk of being born prematurely must be weighed against the risk of PROM. Previously it was recommended that delivery be carried out as if the baby was term. [11] [8] A 2017 Cochrane review however found waiting resulted in better outcomes when pregnancy is before 37 weeks. [5]
Preterm premature rupture of membranes (PPROM) is when water breaks both before the onset of labor and before the pregnancy's 37 week gestation. [ 3 ] [ 4 ] In the United States, more than 120,000 pregnancies per year are affected by a premature rupture of membranes, which is the cause of about one third of preterm deliveries .
A pregnancy is considered term at 37 weeks of gestation. It is preterm if less than 37 weeks and postterm at or beyond 42 weeks of gestation. American College of Obstetricians and Gynecologists have recommended further division with early term 37 weeks up to 39 weeks, full term 39 weeks up to 41 weeks, and late term 41 weeks up to 42 weeks. [24]
[2] [5] The discharge can be milky, clear, green, purulent, bloody, or faintly yellow. [6] The consistency can be thick, thin, sticky, or watery. [5] [6] Nipple discharge may be normal, such as milk in late pregnancy or after childbirth, and in newborns during the first weeks of life.
An increase in vaginal discharge is common during pregnancy due to hormonal changes. The discharge, known as leukorrhea, is usually thin and milky white. However, if the discharge changes color or consistency significantly, it is essential to consult a healthcare provider. [8]
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Because pH in the upper vagina is normally acidic (pH 3.8–4.5), a vaginal pH test showing a pH of more than 4.5 strengthens a suspicion of rupture of membranes in case of clear vaginal discharge in pregnancy. [7] Other tests for detecting amniotic fluid mainly include nitrazine paper test and fern test. [8]
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