Management
In a term pregnancy where premature rupture of membranes has occurred, spontaneous labor can be permitted. Current obstetrical management includes an induction of labor at approximately 12 hours if it has not already begun, though many physicians believe it to be safe to induce labor immediately, and consideration of Group B Streptococcal (GBS) prophylaxis at 18 hours.
- Preterm birth:
- Tocolysis is also sometimes used, though its use in this context is controversial. The mother should be admitted to hospital and put under careful surveillance for preterm labor and chorioamnionitis. Induction of labor should happen at around 34 weeks.
- Antenatal steroids if the gestational age is less than 32 weeks.
- Infection
- Maternal: If chorioamnionitis is present at the time of PPROM, antibiotic therapy is usually given to avoid sepsis, and delivery is indicated. If chorioamnionitis is not present, prompt antibiotic therapy can significantly delay delivery, giving the fetus crucial additional time to mature. In preterm premature rupture of membranes (PPROM), antibiotic therapy should be given to decrease the risk of sepsis. Ampicillin or erythromycin should be administered for 7 days
- Fetal: If the GBS status of the mother is not known, penicillin or other antibiotics may be administered for prophylaxis against vertical transmission of Group B streptococcal infection.
Read more about this topic: Premature Rupture Of Membranes
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