Premature Rupture of Membranes - PROM Vs PPROM

PROM Vs PPROM

PROM is rupture of the membranes prior to the onset of labor, while PPROM (Preterm Premature Rupture of Membranes) is rupture of the membranes with a gestation less than 37 weeks, prior to the onset of labor. These are two distinct entities with different causes, different management, and different outcomes—PROM is a variation of normal, whereas PPROM is often caused by subclinical infection and is quite dangerous. PPROM occurs in about 1% of all pregnancies, and about 1/3 of preterm births are associated with PPROM. The outcome is dependent on the gestational age, with those fetuses under 32 weeks gestation having increased risk of pulmonary problems due to lack of lung maturity. In a fetus under 32 weeks gestation with PPROM, antenatal steroids can be given in an effort to enhance lung maturity. If the risk of infection is thought to be less than the risk of premature delivery, then expectant management is done. The risk of premature delivery is thought to less than the risk of infection after 34 weeks, so delivery is performed. The main determinant of lung maturity of the fetus is amniotic fluid (usually sampled from vaginally pooled fluid) that has phosphatidyl glycerol present.