Preterm Prelabour Rupture Of Membranes

Question 1

PPROM is associated with what percentage of preterm deliveries?

Answer 1

40%

Question 2

What complications can occur?

Answer 2

Fetal: prematurity, infection, pulmonary hypoplasia
Maternal: chorioamnionitis

Question 3

What investigations should be done?

Answer 3

Sterile speculum to look for pooling of fluid in the posterior vaginal vault
Digital examination should be avoided due to infection risk
USS - may show oligohydramnios

Question 4

How is it managed?

Answer 4

Admission
Regular observations to ensure chorioamnionitis not developing
Oral erythromycin for 10 days
Antenatal corticosteroids to reduce RDS risk

Question 5

Delivery should be considered at…

Answer 5

34w - there is trade off between increased risk of chorioamnionitis with a decreased risk of RDS as pregnancy progresses