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Preterm Prelabor Rupture of Membranes (pPROM)

Table of Contents


Topic Overview

Before a baby is born, the amniotic sac breaks open, causing amniotic fluid to gush out or, less commonly, to slowly leak. When this happens before contractions start, it is called prelabor rupture of membranes (PROM). PROM can occur at any time during pregnancy.

When PROM occurs before 37 completed weeks of pregnancy, it usually leads to preterm labor. You may hear this early PROM referred to as preterm prelabor rupture of membranes, or pPROM.

PROM is often unexpected, and the cause is often hard to identify. Known causes of PROM include:

Course of pPROM

Preterm labor usually begins shortly after pPROM occurs. Sometimes, when a slow leak is present and infection has not developed, contractions may not start for a few days or longer. In general, the later in a pregnancy PROM occurs, the sooner the onset of labor.

Sometimes a leak high up in the amniotic sac may reseal itself so that preterm labor does not start or subsides.

In rare cases, a pregnancy can be carried to term if pPROM occurs in the second trimester.

Standard treatment for pPROM

Standard treatment for pPROM includes antenatal corticosteroid medicines, which are used to speed up fetal lung maturity at or before 34 weeks of pregnancy.

Other treatment for pPROM

Other treatment for pPROM may include:

Controversial treatment for pPROM

After amniotic membranes have ruptured, tocolytic medicine is less effective in slowing or stopping preterm labor contractions. But tocolytic medicine is sometimes used to delay a preterm birth long enough for antibiotics and antenatal corticosteroid medicine to work (24 hours) or long enough to transport the mother to a hospital that has a neonatal intensive care unit (NICU).1


References

Citations

  1. American Academy of Pediatrics and American College of Obstetricians and Gynecologists (2007). Obstetric and medical complications. In Guidelines for Perinatal Care, 6th ed., pp. 175–204. Elk Grove Village, IL: American Academy of Pediatrics.

Credits for Preterm Prelabor Rupture of Membranes (pPROM)

Current as of: June 16, 2021

Author: Healthwise Staff
Medical Review: Sarah Marshall MD - Family Medicine
Adam Husney MD - Family Medicine
Kathleen Romito MD - Family Medicine
Kirtly Jones MD - Obstetrics and Gynecology
Heather Quinn MD - Family Medicine


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