preterm premature rupture of membranes
Also written as: PPROM — Preterm Premature Rupture of Membranes
Rupture of fetal membranes before 37 weeks of gestation and prior to the onset of labor, requiring careful management to balance infection risk against prematurity complications.
Full Definition
Preterm premature rupture of membranes (PPROM) occurs when the amniotic sac breaks before 37 completed weeks of pregnancy and before labor begins. This condition complicates approximately 3% of pregnancies and accounts for about one-third of preterm births. PPROM presents significant clinical challenges as it increases risks of infection (chorioamnionitis, neonatal sepsis), cord prolapse, and placental abruption, while also potentially leading to oligohydramnios and pulmonary hypoplasia if occurring early in pregnancy. Management involves careful assessment of gestational age, fetal lung maturity, and signs of infection to determine whether to pursue expectant management with close monitoring or proceed with delivery. The condition is diagnosed through clinical examination, speculum exam showing pooling of amniotic fluid, and confirmatory tests such as nitrazine or ferning tests.
Usage
Usage note: Distinguish clearly from term PROM (≥37 weeks) in clinical documentation; use consistent abbreviation PPROM.
In Context
- "The patient presented at 32 weeks with PPROM and was started on latency antibiotics and corticosteroids for fetal lung maturation." — obstetric admission note
- "Expectant management of preterm premature rupture of membranes continued for 48 hours before signs of chorioamnionitis prompted delivery." — labor and delivery summary