Preterm Premature Rupture of Membranes

Question 1

What is PPROM?

Answer 1

Rupture of membranes before 37 weeks gestation and prior to onset of labour

Question 2

What are complications of PPROM?

Answer 2

Foetal
-prematurity
- Infection
- Pulmonary hypoplasia

Maternal
- chorioamnionitis

Question 3

What is the management of PPROM?

Answer 3

Abx therapy
- erythromycin 250mg QDS prophylactically

Steroids
- if <34 weeks
- 2 x 12mg IM betamethasone 24 hours apart or 4x6mg IM dexamethasone every 12 hours

MgSO4
- neuroprotection if <30 weeks

Delivery
- expectant- if no signs of infection and stable, requires close monitoring
- delivery- if signs of infection, foetal distress or 34-37 weeks gestation

Question 4

What are risks of premature delivery to the baby?

Answer 4

Increased mortality
Resp distress syndrome
Intraventricular haemorrhage
Necrotising enterocolitis
Chronic lung disease
Hypothermia
Infection
Retinopathy of prematurity
Hearing problems