Don’t deliver baby just because waters break

Let nature take course to cut risk of early births, say doctors

THOUSANDS of premature births could be avoided under new guidance advising doctors to delay delivering a baby even if a mother’s waters break early.

Women should be given the option to continue their pregnancy until the baby comes naturally to avoid the harm that can occur with a premature birth, the Royal College of Obstetricians and Gynaecologists suggests.

Every year the waters of 23,000 women break early, defined as before 37 weeks of pregnancy. Often in these cases the pregnancy is artificially induced and the baby delivered, even if it means a very premature birth.

But the new guidance says continuing with the pregnancy until 37 weeks is often safer for the baby. It adds women should be given antibiotics to avoid infection and be closely monitored to make sure there are no complications.

In about half of cases women will go into labour spontaneously within a week of their waters breaking. And in some pregnancies a complication will mean doctors advise delivering the baby as soon as possible.

But with specialist care, the pregnancy can be continued for many weeks, letting the baby develop in the womb for as long as possible.

Waters breaking early – known by the medical term preterm pre-labour rupture of membranes (PPROM) – affects 3 per cent of pregnancies and is associated with up to 40 per cent of premature births in the UK.

Doctors hope the new guidance will reduce the number of premature births, cutting the risk of developmental problems.

Consultant obstetrician Dr Andrew Thomson, author of the new guidelines, said: ‘PPROM is an uncommon but potentially serious condition with significant health risks to a woman and her baby.

‘Evidence shows that waiting for labour to begin may be the best option for a healthier outcome unless there is a reason for the baby to be born immediately. Every pregnancy will be different and each woman’s individual preferences need to be considered when deciding on the timing of birth.

‘All maternity units across the country are encouraged to follow these guidelines, which should improve health outcomes for both mother and baby.’ A spokesman for the Little Heartbeats support group said: ‘Women have rarely heard of PPROM before it happens to them and understanding of the condition is inconsistent across the medical profession.

‘It is essential that women and their partners are provided with all the information they need to make informed decisions, and with ongoing emotional support.’

Lia Brigante, of the Royal College of Midwives, said: ‘This is important guidance that will help to improve the care and safety of pregnancies for women. We urge maternity services to use it.’