Periviable Premature Rupture of Membranes

Obstet Gynecol Clin North Am. 2020 Dec;47(4):633-651. doi: 10.1016/j.ogc.2020.08.007. Epub 2020 Oct 7.


Periviable deliveries (less than 26 weeks) are a small percentage of deliveries but account for a disproportionately high number of long-term morbidities. Few studies describe interventions and outcomes for periviable preterm premature rupture of membranes (PPROM). The available reports may include only those neonates who received resuscitation, making interpretation and application difficult. Counseling should consider the impact of oligohydramnios on fetal lung development. This article discusses standard and experimental interventions that may offer neonatal benefit. Antenatal corticosteroids, antibiotics, and magnesium sulfate may improve outcomes but data to support an improvement in outcome are limited. Studies specifically evaluating these interventions are needed.

Keywords: Amnioinfusion; Antenatal corticosteroids; Latency; Periviable birth; Preterm premature rupture of membranes (PPROM); Pulmonary hypoplasia.

Publication types

  • Review

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use
  • Amniotic Fluid
  • Anti-Bacterial Agents / therapeutic use
  • Bronchopulmonary Dysplasia / epidemiology
  • Cerclage, Cervical / methods
  • Chorioamnionitis / epidemiology
  • Female
  • Fetal Membranes, Premature Rupture / diagnosis
  • Fetal Membranes, Premature Rupture / therapy*
  • Fetal Viability*
  • Gestational Age
  • Humans
  • Infant, Extremely Premature
  • Infant, Newborn
  • Infant, Premature, Diseases / epidemiology
  • Magnesium Sulfate / therapeutic use
  • Pregnancy
  • Pregnancy Outcome
  • Premature Birth


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

Supplementary concepts

  • Preterm Premature Rupture of the Membranes