Late in the pregnancy, the identification of breaking of the water bag is very important in the management of the labor as well as to prevent any infections. There are several other symptoms which can be misinterpreted as passage of water followed by breakage of membranes. Some conditions which could mimic rupturing of the water bag are,
1. Passage of urine
2. Discharge following Candida infection
3. False rupture or hind rupture of the membranes
Some of the complications associated with undiagnosed or even following diagnosis of a ruptured water bag are,
2. Premature labor
3. Cord prolapse
Thus, in order to prevent these complications, there are several means of identifying whether the water broke or if it is some other condition that was mentioned earlier.
Usually at the time of breakage of the membrane, it is most likely that the mother is in the hospital. Thus, there may be other signs of labor such as contractions, passing of blood stained discharge…etc. In such instances, there can be a gush of water which passes suddenly and will be easy to recognize as being resulted from ruptured membranes.
But, at times, the rupture would not give rise to a gush of water but only a small trickle. There might not be any associated symptoms which make it very difficult for the mother to recognize it or differentiate it.
The other factor which can be used in distinguishing it from similar causes is the water being clear as well as devoid of any odor. If the mother passes urine, the water will appear yellowish and it can give rise to the smell of ammonia. In case of discharge due to an infection, mostly candida infection, the discharge can be thick as well as whitish in appearance.
At instances, the rupture of the membranes would give rise to descent of the foetal head and thus the mother can feel a slight heaviness in the pelvic region. The amount of descent as well as feeling of heaviness will depend on the presentation of the foetus, amount of fluid that has come out following the rupture as well as the adequacy of the pelvis.
What should the mother do?
If you guess that there has been a rupture in the membrane, you should not hesitate in calling your practitioner and obtain his advice on proceeding ahead. This can most likely involve the mother being admitted and observed for other signs of progression as well as assessing the foetal well being. A CTG and an Ultrasound scan will most often follow and if the contractions do not appear within 24 hours after the rupture, it is likely that your obstetrician will induce labor depending on the gestation.
If a membrane rupture has progressed beyond 24 hours without notice, it is likely that the mother will need cover with antibiotics and the possibility of infection be suspected in the baby as well.