ACOG Practice Bulletin No. 188: Prelabor Rupture of Membranes

Obstet Gynecol. 2018 Jan;131(1):e1-e14. doi: 10.1097/AOG.0000000000002455.


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 prelabor rupture of membranes (also referred to as 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

  • Review

MeSH terms

  • Abruptio Placentae / prevention & control*
  • Adult
  • Advisory Committees / standards
  • Female
  • Fetal Membranes, Premature Rupture / prevention & control*
  • Fetal Membranes, Premature Rupture / therapy*
  • Gestational Age
  • Humans
  • Obstetric Labor, Premature / prevention & control
  • Practice Guidelines as Topic*
  • Pregnancy
  • Pregnancy Outcome*
  • Randomized Controlled Trials as Topic
  • United States