Rupture

OF
Membrane
: Done By
Toqa Omar
:DAFINITION
Rupture of membranes (ROM) or amniorrhexis

is a term used during pregnancy to describe a rupture of the 

amniotic sac Normally, it occurs spontaneously at full term
labor  either during or at the beginning of

A premature rupture of membranes (PROM) is a rupture of

.the amnion that occurs prior to the onset of labor
 :Types*

:SROM_1
spontaneous rupture of membranes. This term describes
the normal, spontaneous rupture of the membranes at 
full term. The rupture is usually at the bottom of the uterus,
,cervix over the

causing a gush of fluid. This gush may be quite small (such

as 50ml), or it can be significantly large (200-300ml)
depending upon amount of fluid in the amniotic sac, and to
what extent the fetal head is plugging the hole and
retaining fluid in the sac
_PROM : 2

.premature rupture of membranes 

This term describes
a rupture of the membranes that occurs before the
.onset of labor

_PPROM 3
premature rupture of membranes. This
term describes a rupture of the
membranes that occurs before 37 weeks
.gestation
 AROM _4

.artificial rupture of membranes 

This term describes a rupture of the membranes
by a third party, usually a midwife or obstetrician
. in order to induce or accelerate labor
 *:Effects
When the amniotic sac ruptures, production of prostaglandins
increases and the cushioning between the fetus and uterus is
decreased, both of which are processes that increase the frequency
. and intensity of contractions

On occasion, with the rupture of membranes, particularly if the head

is not engaged, the umbilical cord may prolapse. A cord prolapse is
an obstetrical emergency, as the descending head may block fetal-
.placental circulation

Once the membranes are ruptured, bacteria may ascend and could
.lead to amnionitis and fetal infection
* :Risk factors for PROM
Lack of prenatal care 
Smoking during pregnancy 
Low body weight 
Bleeding from the vagina during the 2nd 
or 3rd trimester
Having had a sexually transmitted disease 
(STD), or an infection in the bag of waters
Being pregnant with more than one baby 