Snapshot A 30-year-old G2P1 woman at 33 weeks of gestation presents to the emergency department saying that her "water broke." She reports that the fluid is a pale yellow color and denies the presence of mucus or blood. External fetal monitoring reveals a reactive fetal heart tracing and no uterine contractions. Speculum exam reveals a closed cervical os with a pool of fluid in the vaginal vault. A swab of her vaginal secretions is obtained and fixed to a glass slide; the view under the microscope is seen in the image. Bedside sonogram shows oligohydramnios and a fetus with cephalic presentation. Introduction Overview login to view 2 more bullets Epidemiology Incidence login to view 1 more bullet Risk factors login to view 6 more bullets ETIOLOGY Pathophysiology login to view 3 more bullets Presentation Symptoms login to view 4 more bullets Physical exam login to view 3 more bullets Studies Vaginal fluid login to view 7 more bullets Tested Differential Urinary incontinence login to view 2 more bullets Increased cervical discharge from infection login to view 2 more bullets Treatment Medical login to view 13 more bullets Complications Chorioamnionitis login to view 4 more bullets Fetal/neonatal death login to view 3 more bullets Prognosis Generally good if occurring > 32 weeks of gestation 90% of patients enter spontaneous labor within 24 hours if ROM occurs at term