Practice Bulletin No. 172: Premature Rupture of Membranes

Obstet Gynecol. 2016 Oct;128(4):e165-77. doi: 10.1097/AOG.0000000000001712.

Abstract

Preterm delivery occurs in approximately 12% of all births in the United States and is a major factor that contributes to perinatal morbidity and mortality (1, 2). Preterm premature rupture of membranes (PROM) complicates approximately 3% of all pregnancies in the United States (3). The optimal approach to clinical assessment and treatment of women with term and preterm PROM remains controversial. Management hinges on knowledge of gestational age and evaluation of the relative risks of delivery versus the risks of expectant management (eg, infection, abruptio placentae, and umbilical cord accident). The purpose of this document is to review the current understanding of this condition and to provide management guidelines that have been validated by appropriately conducted outcome-based research when available. Additional guidelines on the basis of consensus and expert opinion also are presented.

Publication types

  • Practice Guideline
  • Review

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use
  • Anti-Bacterial Agents / therapeutic use
  • Anticonvulsants / therapeutic use
  • Cerclage, Cervical
  • Female
  • Fetal Membranes, Premature Rupture / diagnosis*
  • Fetal Membranes, Premature Rupture / therapy*
  • Gestational Age
  • Humans
  • Magnesium Sulfate / therapeutic use
  • Pregnancy
  • Premature Birth / prevention & control
  • Premature Birth / therapy*
  • Tocolytic Agents / therapeutic use

Substances

  • Adrenal Cortex Hormones
  • Anti-Bacterial Agents
  • Anticonvulsants
  • Tocolytic Agents
  • Magnesium Sulfate