Chapter 36 Preterm prelabour rupture of membranes
Definitions. Prelabour (premature) rupture of membranes (PROM) refers to membrane rupture before the onset of uterine contractions irrespective of gestational age. Preterm prelabour rupture of membranes (PPROM) refers to membrane rupture before the onset of uterine contractions in a pregnancy that is <37 completed weeks of gestation.
Aetiology of PPROM
Risk factors of PPROM
Most cases of PPROM occur in women without risk factors and there is currently no reliable way of predicting and preventing PPROM.
Clinical significance of PPROM
Both mother and fetus are at risk from complications associated with PPROM.
Maternal risks
Fetal risks
Diagnosis
Other causes of fluid loss include leucorrhoea, urinary incontinence, vaginitis, cervicitis, mucus show, semen and vaginal douches.
Management of PPROM
The management of PPROM is determined by several factors, including:
Initial management
PPROM: 34–37 weeks
PPROM: 24–33 weeks
PPROM: <23 completed weeks
Antenatal corticosteroids
Adjuvant antibiotics
Tocolysis
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