Preterm and Term Prelabor Rupture of Membranes (PPROM and PROM)

Excerpt

Prelabor rupture of membranes (PROM) is defined as the rupture of the fetal membranes before the onset of labor contractions. When PROM occurs before 37 weeks gestation, the term preterm PROM (PPROM) is used. Spontaneous labor often follows the rupture of membranes (ROM). At term, a delay in the onset of labor following ROM increases the risk of obstetric complications such as intraamniotic infection and placental abruption. PPROM is a complicated condition where clinicians must balance the risks of prolonging pregnancy with fetal risks of prematurity.

Management of PPROM in the previable and periviable periods can be especially complicated, depending on gestational age, with immediate delivery often recommended after 37 weeks. However, in cases of PPROM, expectant management, corticosteroids, antibiotics, and sometimes tocolytics may be used to extend pregnancy when possible to reduce neonatal risks. Understanding the latest recommendations and the evidence supporting them is essential for clinicians and patients to make informed decisions regarding their care and optimize maternal and fetal outcomes.