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Preterm PROM: Prediction, Prevention, Principles

WATERS, THADDEUS P. MD; MERCER, BRIAN MD

Clinical Obstetrics and Gynecology: June 2011 - Volume 54 - Issue 2 - p 307–312
doi: 10.1097/GRF.0b013e318217d4d3
Preterm Premature Rupture Of The Membranes

Preterm premature rupture of the membranes remains difficult to predict accurately. The majority of those suffering preterm premature rupture of the membrane lack risk factors that might lead to preventative treatments. Its management is centered on an evaluation of the risks and benefits of attempted pregnancy prolongation compared with expeditious delivery. An understanding of the gestational age specific risks for newborn morbidity and mortality is essential to estimate the potential benefits of conservative management. Once the diagnosis of membrane rupture remote from term is made, conservative management to reduce neonatal complications is generally attempted while maintaining vigilance for complications such as infection, umbilical cord compression, or abruption. Concurrent antibiotic therapy and antenatal corticosteroid treatment are typically administered to prolong pregnancy, prevent infection, and reduce gestational age dependent morbidities. Near and at term, particularly if fetal pulmonary maturity has been confirmed, the patient is generally best served by expeditious delivery.

MetroHealth Medical Center, Case Western Reserve University, Cleveland, Ohio

Correspondence: Thaddeus P. Waters, MD, MetroHealth Medical Center, Case Western, Reserve University, 2500 MetroHealth Drive, Cleveland, OH. e-mail: twaters1@metrohealth.org

© 2011 Lippincott Williams & Wilkins, Inc.