Preterm premature rupture of membranes is the rupture of membranes during pregnancy before
37 weeks’ gestation. It occurs in 3 percent of pregnancies and is the cause of approximately one
third of preterm deliveries. It can lead to significant perinatal morbidity, including respiratory
distress syndrome, neonatal sepsis, umbilical cord prolapse, placental abruption, and fetal death.
Appropriate evaluation and management are important for improving neonatal outcomes.
Speculum examination to determine cervical dilation is preferred because digital examination
is associated with a decreased latent period and with the potential for adverse sequelae. Treatment
varies depending on gestational age and includes consideration of delivery when rupture
of membranes occurs at or after 34 weeks’ gestation. Corticosteroids can reduce many neonatal
complications, particularly intraventricular hemorrhage and respiratory distress syndrome, and
antibiotics are effective for increasing the latency period. (Am Fam Physician 2006;73:659-64,
665-6. Copyright © 2006 American Academy of Family Physicians.)