Objective To analyze the effect of nursing intervention under health guidance on the cognition and incision aesthetics of pregnant women with premature rupture of membranes. Methods A total of 62 pregnant women with premature rupture of membranes admitted to Nanjing Maternity and Child Health Care Hospital from January 2020 to August 2020 were randomly divided into control group and observation group, with 31 pregnant women in each group. The control group was given routine nursing, and the observation group was given nursing intervention under health guidance. The awareness, incision aesthetics and self-care ability were compared between the two groups. Results The cognition score of the observation group was higher than that of the control group (P <0.05). The total effective rate of incision aesthetics in the observation group was higher than that in the control group (P <0.05). The self-care ability score of the observation group was higher than that of the control group after intervention (P <0.05). Conclusion Nursing intervention measures under health guidance for pregnant women with premature rupture of membranes can effectively improve pregnant women's awareness of delivery and their own situation, aesthetics of surgical incision and postpartum self-care ability.