Premature rupture of membranes: Difference between revisions
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==PPROM== | ==PPROM== | ||
Preterm premature rupture of membranes (PPROM) is a condition where the amniotic sac leaks fluid before 37 weeks of gestation.<ref name="pmid17674244">{{cite journal |author=Deering SH, Patel N, Spong CY, Pezzullo JC, Ghidini A |title=Fetal growth after preterm premature rupture of membranes: is it related to amniotic fluid volume? |journal=J. Matern. Fetal. Neonatal. Med. |volume=20 |issue=5 |pages=397–400 |year=2007 |pmid=17674244 |doi=10.1080/14767050701280249}}</ref> This can be caused by a bacterial infection or by a defect in the structure of the amniotic sac, uterus, or cervix. In some cases, the leak can spontaneously heal, but in most cases of PPROM, labor begins within 48 hours of membrane rupture. When this occurs, it is necessary that the mother receive treatment to avoid possible infection in the newborn. | Preterm premature rupture of membranes (PPROM) is a condition where the amniotic sac leaks fluid before 37 weeks of gestation.<ref name="pmid17674244">{{cite journal |author=Deering SH, Patel N, Spong CY, Pezzullo JC, Ghidini A |title=Fetal growth after preterm premature rupture of membranes: is it related to amniotic fluid volume? |journal=J. Matern. Fetal. Neonatal. Med. |volume=20 |issue=5 |pages=397–400 |year=2007 |pmid=17674244 |doi=10.1080/14767050701280249}}</ref> This can be caused by a bacterial infection or by a defect in the structure of the amniotic sac, uterus, or cervix. In some cases, the leak can spontaneously heal, but in most cases of PPROM, labor begins within 48 hours of membrane rupture. When this occurs, it is necessary that the mother receive treatment to avoid possible infection in the newborn. | ||
==Overview== | |||
'''''Rupture of membranes''''' (ROM) is a term used during [[pregnancy]] to describe a rupture of the [[amniotic sac]] at the onset of, or during, [[labor (childbirth)|labor]]. This is colloquially known as "breaking water". A ''premature'' rupture of membranes ([[PROM (medical)|PROM]]) is a rupture that occurs prior to the onset labor. | |||
==Types== | |||
*'''[[PROM (medical)|PROM]]''' = prelabor or premature rupture of membranes | |||
*'''PPROM''' = preterm, premature rupture of membranes | |||
*'''AROM''' = artificial rupture of membranes | |||
*'''SROM''' = spontaneous rupture of membranes | |||
==Risk factors== | |||
*Maternal risk factors for a premature rupture of membranes include [[chorioamnionitis]] or [[sepsis]]. | |||
*Fetal factors include prematurity, [[infection]], [[cord prolapse]], or [[malpresentation]]. | |||
==Diagnosis== | |||
Assessment of a rupture of membranes involves taking a proper [[medical history]], a [[gynecological exam]] using a [[speculum]], [[nitrazine]], [[cytologic]] (ferning) tests, and [[ultrasound]]. | |||
==Treatment== | |||
*In a term pregnany where premature rupture of membranes has occurred, spontaneous labour should be permitted. Current obstetrical management includes an induction of labour at approximately 6 hours if it has not already begun, and [[Streptococcus|Group B Streptococcal]] prophylaxis at 18 hours. Some hospitals, birth centers and private midwives do not induce labor at any point after PROM, but rather watch carefully for any signs of infection and ensure that nothing is introduced into the vagina after the PROM, including sterile vaginal exams. | |||
*In [[premature birth]] premature rupture of membranes, [[antibiotic]] therapy should be given to decrease the risk of sepsis. | |||
[[Ampicillin]] or [[erythromycin]] should be administered for 7 days, and [[antenatal steroid]]s if the [[gestational age]] is less than 30 weeks. | |||
[[Tocolysis]] is also used, though its use in this context is controversial. | |||
The mother should be admitted to hospital and put under careful surveillance for preterm labour and [[chorioamnionitis]]. | |||
Induction of labour should happen at around 36 weeks. | |||
[[de:Blasensprung]] | |||
{{WH}} | |||
{{WS}} | |||
[[Category:Overview complete]] | |||
[[Category:Disease]] | |||
[[Category:Obstetrics]] | |||
==References== | ==References== | ||
Revision as of 14:17, 23 September 2020
| Premature rupture of membranes | |
| ICD-10 | O42 |
|---|---|
| ICD-9 | 658.1 |
| DiseasesDB | 10600 |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Premature rupture of membranes (PROM) is a condition which occurs in pregnancy when the amniotic sac ruptures before the onset of labor. A related term is pPROM which stands for preterm premature rupture of the membranes. This occurs when the rupture happens before 37 weeks gestation and before labor.
PPROM
Preterm premature rupture of membranes (PPROM) is a condition where the amniotic sac leaks fluid before 37 weeks of gestation.[1] This can be caused by a bacterial infection or by a defect in the structure of the amniotic sac, uterus, or cervix. In some cases, the leak can spontaneously heal, but in most cases of PPROM, labor begins within 48 hours of membrane rupture. When this occurs, it is necessary that the mother receive treatment to avoid possible infection in the newborn.
Overview
Rupture of membranes (ROM) is a term used during pregnancy to describe a rupture of the amniotic sac at the onset of, or during, labor. This is colloquially known as "breaking water". A premature rupture of membranes (PROM) is a rupture that occurs prior to the onset labor.
Types
- PROM = prelabor or premature rupture of membranes
- PPROM = preterm, premature rupture of membranes
- AROM = artificial rupture of membranes
- SROM = spontaneous rupture of membranes
Risk factors
- Maternal risk factors for a premature rupture of membranes include chorioamnionitis or sepsis.
- Fetal factors include prematurity, infection, cord prolapse, or malpresentation.
Diagnosis
Assessment of a rupture of membranes involves taking a proper medical history, a gynecological exam using a speculum, nitrazine, cytologic (ferning) tests, and ultrasound.
Treatment
- In a term pregnany where premature rupture of membranes has occurred, spontaneous labour should be permitted. Current obstetrical management includes an induction of labour at approximately 6 hours if it has not already begun, and Group B Streptococcal prophylaxis at 18 hours. Some hospitals, birth centers and private midwives do not induce labor at any point after PROM, but rather watch carefully for any signs of infection and ensure that nothing is introduced into the vagina after the PROM, including sterile vaginal exams.
- In premature birth premature rupture of membranes, antibiotic therapy should be given to decrease the risk of sepsis.
Ampicillin or erythromycin should be administered for 7 days, and antenatal steroids if the gestational age is less than 30 weeks. Tocolysis is also used, though its use in this context is controversial. The mother should be admitted to hospital and put under careful surveillance for preterm labour and chorioamnionitis. Induction of labour should happen at around 36 weeks. de:Blasensprung
References
- ↑ Deering SH, Patel N, Spong CY, Pezzullo JC, Ghidini A (2007). "Fetal growth after preterm premature rupture of membranes: is it related to amniotic fluid volume?". J. Matern. Fetal. Neonatal. Med. 20 (5): 397–400. doi:10.1080/14767050701280249. PMID 17674244.