Premature Rupture of Membranes

Premature rupture of membranes (PROM) occurs when the gestational membranes rupture before the commencement of labor. There are an assortment of associated factors which weaken the membrane and facilitate rupture. The patient will typically present to the emergency setting with a simple complaint of feeling fluid (not blood) from the vagina without associated labor contractions. The greatest complication of PROM is infection manifesting in chorioamnionitis which can be quite dangerous for both the mother and fetus. Ergo, examinations and interventions should only be performed in a sterile fashion or deferred until necessary. The physical exam is rarely sufficient to rule out PROM, but highly specific and sensitive fluid commercial testing modalities are available for diagnosis. Depending on the gestational age and wellbeing of the fetus, management can range from expectant management to prophylactic antibiotics and glucocorticoids, to delivery.