Term prelabour rupture of membranes

What it is

Pre labour rupture of membrane is rupture of membranes with vaginal loss of amniotic fluid before labour has begun. Two things must be confirmed to call it that: ruptured membranes with vaginal leakage, and the absence of uterine contractions indicative of the start of labour.

The protocol carries two lines for where preterm ends, and they do not agree. Its list of abbreviations defines TPROM as term PROM after 37 completed weeks of gestation and PPROM as pre term PROM before 34 completed weeks of gestation, while its introduction on the next page says rupture can occur when the fetus is immature, before 37 weeks, which is PPROM, or when it is mature at term, which is PROM. The one that is acted on is the 34 week line: the management page and the time of delivery page both split into pPROM under 34 weeks on one side, and pPROM between 34 and 37 weeks together with tPROM at or after 37 weeks on the other, and the two sides are managed differently.

PROM complicates approximately 8% of pregnancies and is generally followed by prompt onset of spontaneous labour and delivery; the majority of women managed expectantly will give birth within 28 hours of membrane rupture. The most significant maternal risk of tPROM is intrauterine infection, a risk that increases with the duration of membrane rupture. Fetal risks are umbilical cord compression and ascending infection.