Bacteria Presence Linked with Premature 'Water Breaking'

There is an association between the presence of bacteria and premature water break, according to researchers at Duke Medicine report.

Some women experience a condition known as premature rupture of membranes (PROM), when a membrane called the amniotic sac breaks before labor and at less than 37 weeks of pregnancy. 

This sac holds the amniotic fluid that surrounds the baby in the womb. The latest study suggests that the amniotic sac isn't as sterile as it is generally assumed to be. Some women have high levels of bacteria on the sac, which could lead to the sac thinning and eventually, breaking.

Fetal membranes are composed of two fetal cell layers, the amnion and chorion. The membranes play an important role during pregnancy.

"Complications of preterm births can have long-term health effects for both mothers and children," said study author Amy P. Murtha, associate professor of obstetrics and gynecology at Duke University School of Medicine. "Our research focuses on why the fetal membranes, or water sac, break early in some women, with the overall goal of better understanding the mechanisms of preterm membrane rupture."

Previous research has shown that chorion has more cell death during a bacterial infection.

In the present study, researchers obtained samples from 48 women- including those with PPROM, preterm and term patients. Researchers measured chorion thinning and bacterial infection in membrane specimens collected from places, both around the rupture and far from it, the news release said.

They found that all women had chorion thinning and bacterial infection near the rupture site. However, bacterial load was higher in women with PPROM. But, unlike other cases, chorion thinning wasn't restricted to the ruptured site, but existed throughout the membrane.

Also, contrary to popular belief, the fetal membrane wasn't a sterile environment and had several types of bacteria.

Researchers said that they are conducting further studies to see if a specific class of bacteria are associated with membrane thinning.

"For instance, if we think that certain bacteria are associated with premature rupturing of the membranes, we can screen for this bacteria early in pregnancy. We then might be able to treat affected women with antibiotics and reduce their risk for PPROM," Murtha said in a news release. "Our research is several steps away from this, but it gives us opportunities to explore potential targeted therapeutic interventions, which we lack in obstetrics."