Pregnant women who suffer from premature breaking of the waters should be given the chance to continue the pregnancy to term, according to guidelines published today.
The guidelines set out how women can be supported to delay labour following preterm, prelabour rupture of membranes.
The Royal College of Obstetricians and Gynaecologists says that even if the waters break at 24 weeks, it is possible for a pregnancy to continue until 37 weeks. If this can be achieved, it will reduce the risk of premature birth, according to the guidelines.
These women should be offered antibiotics to prevent infection and closely monitored, the guidance says. It also calls for additional emotional support for the woman and her partner – and says the baby should be born in a unit with neonatal staff and facilities.
The guidelines have been launched during the college’s world congress in London.
Obstetrician Dr Andrew Thomson, who developed the guidance, said: "PPROM is an uncommon, but potentially serious condition with significant health risks to a woman and her baby. Evidence shows that waiting for labour to begin may be the best option for a healthier outcome – unless there is a reason for the baby to be born immediately.
"Every pregnancy will be different, and each woman’s individual preferences need to be considered when deciding on the timing of birth."
He added: “All maternity units across the country are encouraged to follow these guidelines which should improve health outcomes for both mother and baby.”
Ciara Curran and Rachel Johnson, of the Little Heartbeats support group, said: “When waters break early in pregnancy it can be a really emotionally challenging time for parents and the choices that need to be made can be extremely difficult.
"It is essential that women and their partners are provided with all the information they need to make informed decisions, and with ongoing emotional support.”
Care of Women Presenting with Suspected Preterm Prelabour Rupture of Membranes from 24+0 Weeks of Gestation. RCOG 17 June 2019
https://obgyn.onlinelibrary.wiley.com/doi/10.1111/1471-0528.15803
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