What Causes Water to Break at 20 Weeks?

The term “water breaking” typically refers to the rupture of the amniotic sac during pregnancy, which releases the amniotic fluid that surrounds and protects the developing fetus. When the water breaks before the 37th week of pregnancy, it is considered premature rupture of membranes (PROM) or preterm premature rupture of membranes (PPROM) if it occurs before 37 weeks but after 20 weeks. There are several potential causes and risk factors for PROM or PPROM at 20 weeks or earlier, including:

  1. Infection: In some cases, infections in the genitourinary tract, such as urinary tract infections or sexually transmitted infections, can lead to inflammation and weakening of the amniotic membranes, increasing the risk of early rupture.
  2. Cervical insufficiency: Cervical insufficiency is a condition in which the cervix opens or shortens prematurely during pregnancy, putting pressure on the amniotic sac and potentially causing it to rupture prematurely.
  3. Physical trauma: Trauma to the abdomen, such as a car accident or a fall, can sometimes lead to the premature rupture of the amniotic sac.
  4. Multiple pregnancies: Women carrying twins, triplets, or more are at a higher risk of PROM or PPROM due to increased pressure on the cervix and uterus.
  5. Smoking: Smoking during pregnancy has been associated with a higher risk of preterm birth, including premature rupture of membranes.
  6. Previous history: A history of PROM or PPROM in a previous pregnancy increases the risk of it happening again in subsequent pregnancies.
  7. Amniotic sac abnormalities: In some cases, structural abnormalities of the amniotic sac or membranes can make them more prone to rupture prematurely.
  8. Unknown causes: In many cases, the exact cause of PROM or PPROM remains unknown.

Premature rupture of the amniotic sac can have serious consequences for both the mother and the baby. It can lead to preterm labor, which carries an increased risk of complications for the baby, such as respiratory distress syndrome, infections, and developmental issues. For the mother, it can lead to infections and other complications.

If a woman’s water breaks before 37 weeks of pregnancy, it is important to seek immediate medical attention. The healthcare provider will assess the situation, monitor the mother and baby, and determine the best course of action, which may include hospitalization, antibiotics, and interventions to delay delivery if possible to allow the baby’s lungs to mature further. The goal is to provide the best possible care to ensure the health and well-being of both mother and baby.