gynecology and obstetrics
Prelabor Rupture of Membranes (PROM)
Introduction
Prelabor rupture of membranes is leakage of amniotic fluid before onset of labor. Diagnosis is clinical. Delivery is recommended when gestational age is≥34 weeks and is generally indicated for infection or fetal compromise regardless of gestational age. Prelabor rupture of membranes (PROM) may occur at term (≥37 weeks) or earlier (called preterm PROM if<37 weeks). Preterm PROM predisposes to preterm delivery. PROM at any time increases risk of the following: Infection in the woman ( Intraamniotic Infection [chorioamnionitis]), neonate ( Fetal Presentation, Position, and Lie (Including Breech Presentation) None Placental Abruption (Abruptio Placentae) None Group B streptococci andEscherichia coliare common causes of infection. Other organisms in the vagina may also cause infection. PROM can increase risk of Intracranial Hemorrhage in Neonates in neonates; intraventricular hemorrhage may result in neurodevelopmental disability (eg, Prolonged preterm PROM before viability (at<24 weeks) increases risk of limb deformities (eg, abnormal joint positioning) and pulmonary hypoplasia due to leakage of amniotic fluid (called Potter sequence or syndrome). The interval between PROM and onset of spontaneous labor (latent period) and delivery varies inversely with gestational age. At term,>90% of women with PROM begin labor within 24 hours; at 32 to 34 weeks, mean latency period is about 4 days. 