Premature rupture of membranes (PROM) refers to membrane rupture before the onset of uterine contractions; preterm PROM (PPROM) refers to PROM before 370/7ths weeks of gestation.
The management of PPROM is among the most controversial issues in perinatal medicine. Points of contention include:
- Expectant management versus intervention
- Use of tocolytics
- Duration of administration of antibiotic prophylaxis
- Timing of administration of antenatal corticosteroids
- Methods of testing for maternal/fetal infection
- Timing of delivery.
Risk factors, diagnosis, and management of PPROM at 24 to 37 weeks of gestation will be discussed here. Issues specifically relating to management of PROM prior to 24 weeks of gestation and at term are discussed separately. (See "Midtrimester preterm premature rupture of membranes" and "Management of premature rupture of the fetal membranes at term".)
Preterm premature rupture of membranes (PPROM) occurs in 3 percent of pregnancies and is responsible for, or associated with, approximately one-third of preterm births .