Complications of PROM

Premature rupture of membranes (PROM) is a common condition which occurs in an estimated 8-10% of all births.1 In most cases, it can be effectively managed if diagnosed early enough but preterm PROM (pPROM) is implicated in between 18-20% of perinatal deaths.1 The key to avoiding this statistic is accurate diagnosis of preterm rupture of membranes and allowing proper patient management and timely intervention.

Early Delivery and PROM

Early delivery is the most common complication of PROM. 95% of women with PROM at term will go into labor within 24 hours.2 According to research by the American Congress of Obstetricians and Gynecologists, PROM is associated with one third of all preterm births.3 Other studies have demonstrated that 57% of patients with midtrimester pPROM (between 16 and 24 weeks) deliver within a week.4

In at- or near-term pregnancies (33 weeks or later), or other situations where pulmonary maturity permits it, allowing or inducing labor is often the best way of reducing the risk of complications from PROM.

Other Complications of PROM

When early labor does not occur or should not be induced, patients with PROM should be monitored for the following potential complications:

  • Infection
  • Placental abruption
  • Umbilical prolapse
  • Respiratory distress syndrome

Several methods have been suggested for the management of PROM. Modified bed rest in a hospital setting can encourage the re-accumulation of amniotic fluid and facilitate the ongoing assessment of fetal heart rate and pulmonary maturity. It is also important to monitor the potential complications listed above.

Other recommendations include the administration of a 48 hour course of antibiotics, given intravenously, to prolong pregnancy and prevent infection. The use of tocolytics to prolong the latency period has not been properly evaluated. As of 2007, the ACOG has stated that “a specific recommendation for or against tocolysis administration cannot be made.”2 Antenatal corticosteroids can also be given at 32 weeks or sooner to reduce the potential for respiratory distress syndrome, hyaline membrane disease and other contributors to perinatal mortality.

  • Caughey AB et al. Contemporary Diagnosis and Management of Preterm Premature Rupture of Membranes. Rev. Obstet. Gynecol. 2008;1(1):11–22.
  • Hannah ME et al. Induction of labor compared with expectant management for prelabor rupture of the membranes at term. N Engl. J Med. 1996;334:1005–10.
  • ACOG Practice Bulletin No. 80: premature rupture of membranes. Clinical management guidelines for obstetrician-gynecologists. Obstet. Gynecol. 2007 Apr;109(4):1007-19.
  • Schucker JL, Mercer BM. Midtrimester premature rupture of the membranes. Semin. Perinatol. 1996;20:389–400.

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