Premature rupture of membranes
(PROM) is the rupture of the fetal
membranes before the onset of
labor. In most cases, this occurs
near term, but when membrane rupture
occurs before 37 weeks’ gestation, it is known
as preterm PROM. Preterm PROM complicates
approximately 3 percent of pregnancies
and leads to one third of preterm births.1
It
increases the risk of prematurity and leads
to a number of other perinatal and neonatal
complications, including a 1 to 2 percent risk
of fetal death.2
Physicians caring for pregnant
patients should be versed in the management
of preterm PROM because rapid diagnosis
and appropriate management can result in
improved outcomes. Figure 1 is an algorithm
for management of preterm PROM. PROM between 16 and 26 weeks’ gestation
determined that 57 percent of patients delivered
within one week, and 22 percent had a
latent period of four weeks. When PROM
occurs too early, surviving neonates may
develop sequelae such as malpresentation,
cord compression, oligohydramnios, necrotizing
enterocolitis, neurologic impairment,
intraventricular hemorrhage, and respiratory
distress syndrome. Complications of preterm
PROM are listed in Table