Pregnant women whose waters break early from 24 weeks, but do not go into labour, should be offered the choice to continue with the pregnancy until 37 weeks of gestation — as long as there are no signs of infection or complications, recommend revised clinical guidelines from the Royal College of Obstetricians and Gynaecologists (RCOG) published today.
The new guidelines state that continuing with the pregnancy closer to term could reduce the risk of the baby being born prematurely which is linked to problems with breathing, feeding and infection, and being admitted to a neonatal unit. A woman and her baby should be monitored closely for signs of infection and her individual circumstances and preferences taken into account.
The revised guidance covers the diagnosis, assessment, care and timing of birth following waters breaking early from 24 weeks and until 37 weeks of gestation.
Other new recommendations in the guidance include:
•Where possible, a baby should be born in a unit with appropriate neonatal staff and facilities, and a woman and her partner offered the opportunity to meet a neonatologist to discuss their baby’s care.
•Additional emotional support should be offered to a woman and her partner during these complicated pregnancies and after birth.
•In a subsequent pregnancy, women should be cared for by an obstetrician with expertise in preterm birth.
•In some circumstances, a woman may be cared for at home, while others may be best suited to be in a maternity unit – this should be considered on a case by case basis.