Premature Rupture of Membranes and Severe Weather Systems

Abstract

There has long been anecdotal evidence of early labor and delivery in severe weather events leading to preterm birth. In particular, significant barometric pressure changes are associated with hurricanes and bomb cyclones. Some authors have related these low pressure weather events to premature rupture of fetal membranes, hypothesizing that the membranes act as an inflated balloon and respond directly to pressure changes. In this article, the key literature including data supporting this hypothesis is reviewed. A simple numerical model, based on a competition between the driving and resisting forces for fetal membrane rupture, is presented. This model provides a quantitative mechanism for membrane failure in the context of storms with low atmospheric pressure. Other sequelae of severe storms that are unrelated to fetal membrane rupture are also discussed. Labor and delivery in the context of major weather events should be understood in a holistic framework that includes both exogenous and endogenous factors relevant to the pregnant patient.

Keywords: PROM; chorioamnion; failure; fetal; membranes; premature; preterm; rupture.

Figure 1

Puncture force for the chorioamnion membrane as a function of gestational age, data from the studies (Oyen et al., 2004, 2006). The data have been split into two groups and fit with linear trend lines, GA ≤ 29 weeks (open squares) and GA≥30 weeks (open circles).

Figure 2

Model for CA membrane stress σ and strength σ_f as a function of gestational age GA. The strength values are calculated from the data in Figure 1 using Equation (1); the stress values for normal and storm atmospheric pressures are calculated from Equation (2) with parameter values as described in the text.