Premature rupture of membranes

Abstract

Prelabor rupture of membranes (PROM) complicates less than 10% of pregnancies and is defined as rupture of membranes before the onset of labor. However, if PROM occurs before 37 weeks, it accounts for 30-40% of cases of prematurity. Management of PROM is influenced by gestational age at the moment of rupture and the presence of complicating factors such as maternal infection, abnormal fetal testing, or labor. An accurate assessment of gestational age and knowledge of the maternal, fetal, and neonatal risks are essential to appropriate evaluation and care of these patients. Antibiotics administration after diagnosis of preterm prelabor rupture of membranes (PPROM) is able to prolong latency period. Corticosteroids and magnesium sulfate are indicated to reduce neonatal morbidities. Despite advances in neonatal care and apparent improvement in neonatal outcomes, longer-term neonatal outcomes after midtrimester PPROM are largely unknown. Management still has a clinical dilemma in the last decades.