Premature Rupture of Membranes
Written on March 27, 2009 by steven
Premature rupture of the membranes(PROM) occurs as an uncontrollable gush or leakage of fluid. By definition, PROM is rupture of the membrane that occurs more than 12 hours before the onset of labor. If this occurs before 37 weeks gestation, it may be called preterm premature rupture o/the membranes(PPROM).
In the past, due to concern that prolonged rupture of membranes would lead to maternal and fetal infection, babies were all delivered shortly after rupture, regardless of gestational age. Research has not shown this to be beneficial to mother or baby.
Today, one of two care paths generally is followed when a woman has PPROM without labor:
1.
Nothing is done except to wait for labor with monitoring of maternal temperature and avoidance of all vaginal examinations.
2. Corticosteroid therapy is initiated, with or without medications to try to stop labor.
Delivery is only induced in the presence of maternal fever, indicating infection. Most women with PPROM will be in labor, either immediately or within 2 days.
Women with ruptured membranes before 37 weeks usually are admitted to the hospital for observation. The woman may be discharged home before the baby is born if the leakage of fluid stops and certain other conditions exist. The baby should be in the vertex or head down position; there must be no sign of infection; the woman must be able to rest and avoid vaginal intercourse at home; the woman or somebody in her family must be able to read a thermometer; the woman must be able to return for prenatal care visits at least weekly. This is a decision to be made individually for each woman.
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