Premature Rupture of Membranes (PROM) & Preterm Premature Rupture of Membranes (PPROM)
New Jersey Lawyers for Premature Rupture of Membranes Injuries
The classic sign of a baby about to be born is what has been popularly as a woman’s water breaking. You see it in movies, when the pregnant woman announces that her water broke, followed by a rush to the hospital. But when the membranes that hold not water but amniotic fluid break too early, called premature rupture of membranes or PROM, then the clock starts ticking down to urgent and decisive action on the part of your medical team. Premature birth is considered weeks before the assumed 42 weeks of a full-term pregnancy, typically prior to 37 weeks. It is estimated that about 3% of pregnant women experience PROM, which is responsible for causing approximately one-third of premature births. Important decisions must be made when the membranes rupture too soon prior to birth. For example, doctors and medical professionals must determine whether immediate delivery is necessary to protect the child’s health and survival.
Prompt diagnosis and knowing what to do when, what drugs to administer and how much, are crucial protection for the mother and baby. When your doctor fails to confirm PROM or takes too long to diagnose PROM, thus delaying treatment, the health risks to the unborn baby are high. The race to beat infection and premature birth complications is a complex puzzle with little room for error. When doctors do make errors with the diagnosis and management of prematurely ruptured membranes, the injuries may be devastating. Babies are often born with brain damage, lifelong respiratory illnesses, or organ damage if they do, indeed, live. PROM is not a rare condition, so physicians who are not prepared to quickly take the necessary steps to ensure the safety of mother and baby may be considered negligent and held liable through medical malpractice and birth injury claims.
If healthcare providers neglected to identify the signs of premature membranes rupturing or failed to take quick and proper action when handling PROM, contact our New Jersey offices at (866)-708-8617 to speak to an attorney who can advise and assist you. We offer free case reviews and consultations, so please do not hesitate to reach out to explore your legal options.
Importance of Making the Right Decisions when Membranes Rupture Too Early
Premature Rupture of Membranes (PROM) is an emergency situation and can be extremely dangerous to the unborn child. Babies born prematurely suffer more respiratory problems and severe infections, which can lead to fetal or newborn death. Therefore, medical authorities recommend speculum examination over digital examination to prevent spreading bacteria and causing infection. This is accomplished by using a device to check for cervical dilation rather than one’s fingers. If membranes rupture closer to 34 weeks into the pregnancy, then preterm delivery must be considered to protect the life of the soon-to-be infant. If early delivery is the choice, the fetus’s lungs will likely be shored up with steroid injections, as the lungs are the last to develop in the fetus at nearly full term. To further protect the pregnant woman and her unborn child, antibiotics are administered to help prevent or treat infections.
Doctors must be prepared to react quickly and rely on their expertise to assess the specific patient in front of them and make the right choices to continue the pregnancy, bettering the chances of fetal survival, or deliver the child early, even with the risks that come with prematurity. Drug treatment with antibiotics is critical and choosing the right medication at the right time is equally important. For a woman whose membranes rupture after 24 weeks but before 32, corticosteroid administration reduces the risk of brain bleeding, respiratory distress, and intestinal problems for the newborn. Delaying the onset of labor for a short period of time with medications may be necessary to get the patient to the hospital and receiving the drug therapy necessary to preserve the baby’s life. However, keeping the expectant mother infection-free is also paramount while she awaits the right time for delivery. All of these are life-altering and possibly, life-saving decisions that medical professionals must make when prematurely ruptured membranes occur.
Risk Factors for Preterm Premature Rupture of Membranes
While lifestyle factors, such as smoking, obesity, and sexually transmitted diseases increase the risk for preterm PROM, other conditions, such as previous premature delivery, vaginal bleeding, polyhydramnios (too much amniotic fluid) and multiple birth may also increase the likelihood of preterm PROM. Realistically, not one but many factors cause the condition.
Signs of Prematurely Ruptured Membranes
Healthcare professionals must take a complete history of a patient, along with a physical exam and follow up tests to diagnose PROM. The individual mother’s story is important information for diagnosing PROM. Women may explain that they knew their water broke when they felt fluid pouring from them, followed by a slow leaking. A visual inspection of pooled fluid in the vagina or leaking from the vagina confirms the membranes ruptured, along with a pH test of the fluid because amniotic fluid is high in alkaline. A woman with prematurely ruptured membranes may also experience vaginal bleeding or a fever. If they had sex recently, there is an added complexity to the diagnostic process, as fluid testing may return a false positive with blood or semen present.
Tests to Confirm PROM Diagnosis
It is critical that PROM is confirmed quickly. What happens afterward depends on the due date of the baby and whether they can be safely delivered early. One thing the treating physician will want to know is how far the cervix is dilated, in order to calculate the next move. On a scale of 0 to 10, the cervix is fully dilated and open to allow the baby’s exit at 10. The obstetrician checks for dilation by inserting a speculum into the vagina to view the cervix. Doctors may also begin testing for STD’s or group B streptococcus, which makes PROM a more likely danger to an infant. Sometimes a sonogram is used to confirm diagnosis of PROM or amniocentesis (testing of the amniotic fluid). A sonogram can also locate the baby’s position in the womb, as well as the placenta and approximate weight of the fetus. Scanning device measurements and calculations help determine how the fetus is faring and how the labor is progressing. Since timing is critical, these predeterminations also help the doctor know when or if to prepare the baby’s lungs for early delivery with the right amount of medication.
Potential Complications from Premature Rupture of Membranes
Most deliveries of PROM pregnancies occur within 24 hours to a week of the ruptured membranes, within which time the healthcare team should be doing all they can to prepare for the preterm newborn. Preterm birth is the primary complication from PROM, which comes with its inherent dangers to the infant. Aside from respiratory distress syndrome and severe breathing problems, preterm babies are more likely to suffer developmental delays from too little amniotic fluid, known as oligohydramnios. They are also susceptible to severe intestinal problems when bacteria flood the intestinal cavity, a condition known as necrotizing enterocolitis. Hemorrhaging and neurological damage are also prevalent in babies whose mothers have PROM.
Other dangers to mother and newborn include umbilical cord compression, which cuts off oxygen and nutrients to the fetus, as well as chorioamnionitis, an infection in the amniotic membranes or uterine wall that can infect the fetus also. Placental abruption or detachment from the uterine wall, also is a serious threat to the survival of the child. All severe prematurity complications can lead to mental and physical deficits that plague the child throughout their lifetime, requiring special care, including physical, occupational, and speech therapies.
Premature Rupture of Membranes and Medical Negligence
There are a host of factors for consideration when a woman experiences PROM or preterm PROM before her child is born. In addition, carrying out and managing the right treatment course and managing the condition before and throughout labor and delivery and thereafter is highly complicated. For instance, providers must be aware of the proper dosage of medication administered to help a preterm baby’s lungs develop. According to medical recommendations, corticosteroids should be given before 32 weeks and after 30 weeks of the pregnancy. A course of antibiotics is also recommended to forestall imminent delivery and to stave off infection or complications from infections, such as pneumonia. Different conditions and predispositions may require different antibiotics. For instance, an antibiotic for an STD is different from one for group B strep. If a pregnant woman is known to have group B strep, antibiotics are necessary to eradicate the infection prior to delivery. They may also need to have a cesarean section birth.
If membranes rupture in the period between 34 and 36 weeks of pregnancy, the doctor is supposed to consider inducing labor rather than waiting for full term and risking chorioamnionitis and a prolapsed umbilical cord. In fact, once the fetus’s lung maturity is ascertained, the physician is tasked with inducing labor. And yet, the decision to move forward or hang back and wait is a consideration involving many factors, including the fetal age and lung development on the one hand, and the risk of infection to mother and child by prolonging labor, on the other hand. If the baby’s lungs are not yet mature, the doctor can administer the medication and wait for another two days before inducing labor.
Whether the appropriate course of action is to prolong the pregnancy a few weeks or to immediately induce and medicate to save the baby’s life, can spell the difference between tragedy and a healthy life with no birth complications. In the reverse, medical malpractice in PROM cases can be disastrous. Some potential acts of negligence include:
- Delayed diagnosis of prematurely ruptured membranes
- Failure to diagnose preterm PROM
- Inaccurate determination of the stage of pregnancy or fetal development
- Failing to administer corticosteroids for lung development
- Not providing the correct antibiotics or giving medication at all
- Improperly handling PROM labor and delivery
- Failing to recognize signs of fetal distress
- Delayed or failure to perform a necessary C-section
Consult a Premature Rupture of Membranes Attorney in NJ Now : Free Consultation
Our dedicated medical malpractice attorneys are familiar with PROM and can be of great assistance when you need to meet your baby’s current and future medical needs and costs after experiencing injuries from negligence. If medical professionals made mistakes or failed to diagnose and manage premature rupture of membranes and you or your baby suffered harm, we can prepare your claim from beginning to end and pursue just compensation from responsible doctors and hospitals. Contact our legal team for knowledgeable counsel and answers to questions you may have about filing a lawsuit for your or your baby’s injuries. Free consultation: (866)-708-8617.
- Preterm Premature Rupture of Membranes: Diagnosis and Management, Am Fam Physician