Preterm premature rupture of membranes
Preterm premature rupture of membranes (PPROM) refers to rupture of membranes prior to 37 weeks of gestation.
It is thought to occur in 0.4-2% of all pregnancies. It however may account for up to one-third of all preterm births (particularly in the United States ).
PPROM will cause a leak of amniotic fluid with resultant reduction in amniotic volumes.
Risk factors include:
While there are studies confirming no increased of intrauterine infection with usage of transvaginal scanning , some recommended transperineal ultrasound instead as a precautionary measure .
Treatment and prognosis
Treatment is often conservative with management options dependent on development of complications. There are some occasional reports of reported "resealing" of the leak with reaccumulation of fluid and normal outcomes. A PPROM in early pregnancy (<20 weeks gestation) generally carries a poor prognosis.
The likelihood of complications is often dependent upon the timing of membrane rupture, the amount of residual amniotic fluid and length of time of persistent oligohydramnios
- main maternal risk is infection
- Arthrogryposis multiplex congenita
- cervical incompetence
- prolonged rupture of membranes
- premature rupture of membranes (PROM)
- germinal matrix haemorrhages
- rupture of membranes
- fetal / neonatal respiratory distress syndrome