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Care after spontaneous rupture of membranes (SRoM)

IntroductionShow [+]Hide [-]

This information explains what happens at the RVI maternity unit after your membranes have ruptured (water’s broken) and labour has not yet started.

Often the membranes rupture, releasing some of the fluid that surrounds the baby, without labour starting straight away. Following spontaneous rupture of the membranes (SRoM) you will be seen in the Maternity Assessment Unit (MAU). The baby’s heartbeat will be monitored and your temperature, pulse and blood pressure checked. If all is well, you will be given the choice to either go home and wait for labour to start spontaneously (for a maximum of 48 hours) this is called conservative management, or to stay in hospital and have your labour augmented (started off) which is termed active management. Whether actively or conservatively managed there is no reported difference in the need for birth by forceps, Ventouse or caesarean section.

Active managementShow [+]Hide [-]

If you opt for active management then you will be transferred to delivery suite as soon as space is available, usually within 24 hours. Your labour will be augmented with a drip (containing Syntocinon) to start the contractions. Because we will be stimulating the contractions, the baby’s heart rate will be monitored continuously during the labour.

Conservative managementShow [+]Hide [-]

If you opt for conservative management you will be asked to return to the MAU once your labour starts or to the Delivery Suite within 36 to 48 hours if labour does not start spontaneously.

If you are in doubt whether to return, please phone the MAU for further advice. If on your return, the membranes have been ruptured for 18 hours or more you will be offered antibiotics during labour. Antibiotics reduce the risk of Group B Streptococcal infection (GBS) in the newborn baby. GBS can result in a serious bacterial infection of the newborn. Giving women in high-risk situations (like SRoM for longer than 18 hours) antibiotics when in labour can prevent most newborn GBS infection. In these women, giving antibiotics in labour reduces the risk of GBS from 1 in 476 to 1 in 8351.

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