[2] Risk factors include infection of the amniotic fluid, prior PROM, bleeding in the later parts of pregnancy, smoking, and a mother who is underweight.

[2] Diagnosis is suspected based on symptoms and speculum exam and may be supported by testing the vaginal fluid or by ultrasound.

[2] Prognosis is primarily determined by complications related to prematurity such as necrotizing enterocolitis, intraventricular hemorrhage, and cerebral palsy.

In PROM, these processes are activated too early:[12] Infection and inflammation likely explains why membranes break earlier than they are supposed to.

To do this, a careful medical history is taken, a gynecological exam is conducted using a sterile speculum, and an ultrasound of the uterus is performed.

[16] Like amniotic fluid, blood, semen, vaginal secretions in the presence of infection,[9] soap,[10] urine, and cervical mucus[8] also have an alkaline pH and can also turn nitrazine paper blue.

[9] Cervical mucus can also make a pattern similar to ferning on a microscope slide, but it is usually patchy[9] and with less branching.

[8] Other conditions that may present similarly to premature rupture of membranes are the following:[8] Women who have had PROM are more likely to experience it in future pregnancies.

However, any woman that has had a history of preterm delivery, because of PROM or not, is recommended to take progesterone supplementation to prevent recurrence.

[11][9] Pre-viable The management of PROM remains controversial, and depends largely on the gestational age of the fetus and other complicating factors.

The risks of quick delivery (induction of labor) vs. watchful waiting in each case is carefully considered before deciding on a course of action.

[11] As of 2012, the Royal College of Obstetricians and Gynaecologists advised, based on expert opinion and not clinical evidence, that attempted delivery during maternal instability increases the rates of both fetal death and maternal death, unless the source of instability is an intrauterine infection.

[18] At any age, if the fetal well-being appears to be compromised, or if intrauterine infection is suspected, the baby should be delivered quickly by induction of labour.

Therefore, as long as the fetus is doing well, and there are no signs of infection or placental abruption, watchful waiting (expectant management) is recommended.

Focusing on the 24–37-week range, the review analysed twelve randomised controlled trials from the "Cochrane Pregnancy and Childbirth's Trials Register", concluding that "In women with PPROM before 37 weeks' gestation with no contraindications to continuing the pregnancy, a policy of expectant management with careful monitoring was associated with better outcomes for the mother and baby.

[27] Antenatal corticosteroids, latency antibiotics, magnesium sulfate, and tocolytic medications are not recommended until the fetus reaches viability (24 weeks).

[11] If PROM occurs before 37 weeks, it is called preterm prelabor rupture of membranes (PPROM), and the baby and mother are at greater risk of complications.

[22] PROM provides a path for disease-causing organisms to enter the womb and puts both the mother and baby at risk for infection.

[8] Low levels of amniotic fluid due to mid-trimester or previable PPROM (before 24 weeks) can result in fetal deformity (e.g. Potter-like facies), limb contractures, pulmonary hypoplasia (underdeveloped lungs),[11] infection (especially if the mother is colonized by group B streptococcus or bacterial vaginosis), prolapsed umbilical cord or compression, and placental abruption.

This case, the chances of the membranes healing on their own and the amniotic fluid returning to normal levels is much higher than spontaneous PROM.

Compared to spontaneous PROM, about 70% of women will have normal amniotic fluid levels within one month, and about 90% of babies will survive.