Can premature rupture of membranes be detected by ultrasound? The difference between premature rupture of membranes and amniotic fluid rupture

Premature rupture of membranes is very dangerous to the fetus, and pregnant mothers should pay special attention to it. So how can we confirm whether it is premature rupture of membranes? Can premature rupture of membranes be detected by B-ultrasound? Does premature rupture of membranes mean the same as broken amniotic fluid?

What is premature rupture of membranes

Premature rupture of membranes is the most common complication in the perinatal period. It is extremely likely to cause serious adverse consequences for pregnant women, parturients, fetuses and newborns.

Premature rupture of membranes refers to the rupture of the membranes in the middle or late stages of pregnancy or before labor, with the amniotic fluid suddenly leaking out of the vagina. If the pregnancy is less than 37 weeks, then premature rupture of membranes in this case is also called premature birth, which is what we often call preterm birth.

Increased amniotic cavity pressure, mycoplasma infection, poor connection between the fetal presenting part and the pelvic entrance, and lack of copper and zinc trace elements in pregnant women may all be causes of premature rupture of membranes.

Premature rupture of membranes is dangerous for both pregnant women and fetuses. It can lead to increased premature birth rates, increased perinatal mortality, and increased intrauterine and puerperal infection rates.

Can premature rupture of membranes be detected by ultrasound?

Poor development or infection of the fetal membranes, a sharp increase in abdominal pressure, excessive uterine tension, uneven pressure in the anterior amniotic sac, mechanical trauma, etc. can all cause premature rupture of the membranes. The nursing diagnosis of premature rupture of the membranes must be taken seriously. So, can B-ultrasound detect premature rupture of the membranes?

B-ultrasound diagnosis of premature rupture of membranes mainly assists in diagnosis by observing the changes in the amount of amniotic fluid and the distribution of amniotic fluid. If the amount of amniotic fluid is significantly reduced compared with the recent or recent days, it can help diagnose premature rupture of membranes; if the distribution of amniotic fluid is limited, such as the large difference between the diameters of the first and second largest amniotic pools, it can assist in diagnosing premature rupture of membranes. In other words, B-ultrasound can detect premature rupture of membranes.

How to diagnose premature rupture of membranes

Premature rupture of membranes seriously endangers women's lives, so timely examination and treatment are needed. How can premature rupture of membranes be diagnosed? This is a very important question. Because this disease is very harmful and has many complications, timely treatment is required to ensure the safety of life. The specific methods for diagnosing premature rupture of membranes are as follows:

1. Vaginal fluid pH test. Normal vaginal fluid pH is 4.5-5.5, and amniotic fluid pH is 7.0-7.5. Vaginal fluid is tested with litmus paper or nitrazine paper. A pH value of ≥6.5 is considered positive, indicating a high possibility of premature rupture of membranes.

2. Vaginal fluid smear examination. Normal vaginal fluid dried smears during pregnancy can be seen with rows of pea-shaped ellipsoids. During premature rupture of membranes, vaginal fluid dried smears can be seen with fern-like crystals, which are amniotic fluid. The smear stained with 0.5% methylene blue can see light blue or unstained fetal skin epithelium and vellus hair; Sudan III staining can see orange fat particles, and 0.5% Nile blue sulfate staining can see orange fetal epithelial cells. The results are more reliable than measuring pH with test paper, and can be confirmed as amniotic fluid.

3. Ultrasound examination. In the late pregnancy, the anterior amniotic sac can be seen under B-ultrasound under normal circumstances, but it cannot be seen under B-ultrasound when the membranes are ruptured prematurely. Ultrasound measurement of the maximum amniotic fluid pool depth (MVP) is considered too low in China if the maximum amniotic fluid depth is less than 3cm or the amniotic fluid index (AF1) is less than 5cm. A significant decrease in the amount of amniotic fluid by more than 30% in a short period of time can assist in the diagnosis of premature rupture of membranes.

Patients with premature rupture of membranes should reduce anxiety, cooperate with treatment, explain the current situation to the pregnant woman and her family, as well as the purpose and significance of the treatment measures taken by medical staff, guide them to cooperate with treatment and monitoring, assist pregnant women with various life care, and reduce anxiety.

What is the difference between premature rupture of membranes and amniotic fluid?

Pregnant women suddenly feel a large amount of fluid flowing out of the vagina, followed by intermittent discharge of a small amount. When the abdominal pressure increases, such as coughing, burping, carrying weight, etc., the amniotic fluid will flow out. The fetal membrane ruptures at the cervical opening, and the amniotic fluid flows out. This is a precursor to the delivery of the fetus, which usually occurs when the cervical opening is dilated by more than 7 cm.

However, there are also some pregnant women who have not experienced obvious uterine contractions and have not urinated, but suddenly have watery vaginal discharge. After treatment, when liquid is discharged again, premature rupture of membranes, also known as premature rupture of water, should be considered. After premature rupture of membranes, in most cases, regular uterine contractions begin immediately. However, there are also cases where regular uterine contractions occur only after a period of time, and inexperienced pregnant women often tend to ignore it.

Due to premature rupture of the membranes, the amniotic fluid flows out, and the inside of the uterus is connected to the outside world through the vagina. Bacteria can easily enter the body and cause intrauterine infection. Pregnant women will have fever, the amniotic fluid will become turbid and produce a peculiar smell, and the fetus may develop sepsis due to intrauterine infection.

Therefore, when the due date is approaching, you should pay attention to changes in your body at any time and place. If you find any abnormalities, such as water breaking, you must be hospitalized immediately to wait for delivery. 20%-25% of pregnant women will experience premature rupture of membranes during delivery.