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1. Premature Rupture of Membranes
(PROM)
MD HASAN MIA
MBBS-4TH YEAR
PMC-13,RANGPUR

2. Definition
Spontaneous rupture of the membranes any time
beyond 28th week of pregnancy but before the
onset of labour is called premature (pre labour)
rupture of membranes.

3.  TERM PROM
When the rupture occurs beyond 37th week but before the onset
of labour it is called term PROM
PRE TERM PROM
When the rupture occurs before the 37th completed weeks it is
called preterm PROM
PROLONGED RUPTURE OF MEMBRANE
Rupture of membrane for 24 hours before delivery is called
prolonged rupture of membrane

4. INCIDENCE
10 % of all pregnancies

5. Causes
 Increased friability of the membranes
 Decreased tensile strength of the membranes
 Polyhydramnios
 Cervical incompetence
 Multiple pregnancy
 Infection – Chorio-amnionitis, UTI, lower genital tract
infections

6. Diagnosis
 Subjective symptom is
Escape of watery discharge per vagina either as a gush or
slow leak.
 Usually confused with
1. Hydrorrhoea gravidarum
2. Incontinence of urine

7. Confirmation of Diagnosis
1. Speculum examination
2. Examination of the collected fluid from posterior fornix
for
 Detection of pH ( 6 – 6.2)
 Ferning pattern
3. 0.1% Nile blue sulphate test – orange blue colouration of
cells
4. USG

8. Investigations
 Complete blood count
 Urine analysis and culture
 High vaginal swab for culture
 Vaginal pool to estimate phosphatidyl glycerol
 USG
 NST

9. Dangers
Preterm labour and prematurity
Ascending infection
Cord prolapse
Dry labour
Fetal pulmonary hypoplasia
R.D.S

12. Management
- Assess gestational age and fetal weight
- Patient not in labour
- Absence of infection and fetal distress
- biophysical profile and NST
To monitor maternal pulse, temperature, FHS and start prophylactic antibiotics
Pregnancy < 34 weeks Pregnancy > 34 weeks Pregnancy > 37 weeks
Expectant management Wait for spontaneous onset Wait for spontaneousto
continue for fetal maturity. of labour for 24 – 48 hours labour for 24 hours
Transfer patient with “fetus in FAILS FAILS
Utero” to equipped centre
Induction of labour Induction of labour
with oxytocin with oxytocin