High level water rupture is a special type of premature rupture of membranes, once the water rupture can not be healed by itself, its management needs to be decided according to the gestational week, maternal and fetal conditions, local medical level and the wishes of the pregnant woman’s family and other aspects. For gestational weeks <24 weeks, due to the high incidence of adverse outcomes in preterm infants and the high risk of maternal infection, it is recommended that labor be induced and abandoned. For 24-27⁺⁶ weeks, the decision can be made according to the wishes of the pregnant woman and her family, such as the request for fetal preservation, fully informed of the risks, it is recommended to refer to the neonatal rescue of hospitals with better conditions for fetal preservation treatment. At 28-33⁺⁶ weeks of gestation, after excluding contraindications to the continuation of pregnancy, the pregnancy can be kept until 34 weeks of gestation and the mother and child will be closely monitored. Induction of labor or cesarean section is not recommended at 34 weeks of gestation and beyond. Premature rupture of membranes is a spontaneous rupture of fetal membranes found before labor, which can lead to preterm labor, chorioamnionitis, neonatal infections, sepsis, and other adverse outcomes, and its prognosis varies with different gestational weeks. If vaginal bleeding occurs, the patient should be seen by the hospital as soon as possible for a definitive diagnosis to avoid delaying treatment.