This is the rupture of the membranes before the onset of labour. The two types are Preterm (before 37 completed weeks) and Term (³37 weeks, but ³ 1 hour before onset of labour).

SYMPTOMS

• Gush or leakage of fluid from the vagina.

SIGNS

• Exclude signs of chorioamnionitis - fever, purulent vaginal discharge, maternal tachycardia and uterine tenderness

• Examine the abdomen for the symphysio-fundal height, presentation, lie and the foetal heart rate.

INVESTIGATIONS

• FBC
• Sterile speculum examination including swab for culture
• Ultrasound scan (if available) for the gestational age, foetal lie and presentation, amniotic fluid volume (normal or reduced), and the placental site. Estimate the foetal weight.

REFER

Patients should be referred to hospital or specialist for further management