PROM Versus pPROM
During pregnancy, the amniotic membrane plays an important role in protecting the fetus up until the onset of labor. Rupture of the membrane fetal (ROM) is a commonly-used blanket term which includes the following conditions:
- Spontaneous rupture of membrane (SROM): SROM is the most common kind of fetal rupture. Commonly referred to as breaking one’s water, it is a natural part of labor that requires no additional management or intervention.
- Artificial rupture of membrane (AROM): In certain cases where labor has been initiated but the amniotic membrane has not been broken, a nurse may perform AROM to expedite delivery and reduce the risk of complications.
- Premature rupture of membrane (PROM): In approximately 8-10% of pregnancies, fetal membranes will rupture before the onset of labor.1 When it occurs at 37 weeks or later, PROM is an easy-to-manage complication of a normal birth. 1
- Preterm premature rupture of membrane (pPROM): PROM that occurs before 37 weeks is known as pPROM. Compared to PROM, preterm PROM is more rare and difficult to manage. The condition has been cited as a cause in as many as 20% of perinatal deaths.1
Managing PROM Vs. pPROM
The distinction between premature ROM and preterm PROM is an important one, with many implications for the treatment and management of complications. Because the risk of infection outweighs the risk of prematurity when PROM is diagnosed at term, labor induction to prompt delivery is recommended to avoid unnecessary complications and their associated costs. Potential complications of delaying induction can include fetal distress, infection, sepsis and placental abruption.
In cases of pPROM, the decision can be more complicated. From 34 weeks onward, labor can be induced if sufficient fetal lung maturity is present and resources are available for monitoring the neonate.
If it is not safe to induce labor, several options are available for managing the potential complications of pPROM. These include everything from simple bed rest to the administration of corticosteroids or antibiotics.
Diagnosing PROM and pPROM
There is little difference between the diagnostic criteria for identifying premature ROM versus preterm PROM. However, pPROM cases are less likely to exhibit observable symptoms such as pooling around the posterior fornix. Because the risks of pPROM are more severe than late-term ROM, the need for an accurate ROM testing method is clear. AmniSure® is the only commercially-available test for PROM and pPROM that is non-invasive, cost-effective and ~99% accurate — making it an essential tool to aid in early detection and intervention of both conditions.
- Caughey, AB et al. Contemporary Diagnosis and Management of Preterm Premature Rupture of Membranes. Rev. Obstet. Gynecol. 2008;1(1):11–22.