HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Mercer, B. M. Search for Related Content PubMed PubMed Citation Articles by Mercer, B. M.

Preterm Premature Rupture of the Membranes

From the Department of Obstetrics and Gynecology, MetroHealth Medical Center, Case Western Reserve University, Cleveland, Ohio.

Address reprint requests to: Brian M. Mercer, MD, MetroHealth Medical Center, Department of Obstetrics and Gynecology, 2500 MetroHealth Drive, Suite G240, Cleveland, OH 44109-1989.

Preterm premature rupture of membranes (PROM) affects over 120,000 pregnancies annually in the United States and is associated with significant maternal, fetal, and neonatal risk. Management of PROM requires an accurate diagnosis as well as evaluation of the risks and benefits of continued pregnancy or expeditious delivery. An understanding of gestational age–dependent neonatal morbidity and mortality is important in determining the potential benefits of conservative management of preterm PROM at any gestation. Where possible, the treatment of pregnancies complicated by PROM remote from term should be directed towards conserving the pregnancy and reducing perinatal morbidity due to prematurity while monitoring closely for evidence of infection, placental abruption, labor, or fetal compromise due to umbilical cord compression. Current evidence suggests aggressive adjunctive antibiotic therapy to reduce gestational age–dependent and infectious infant morbidity. Similarly, review of evaluable data indicates that antenatal corticosteroid administration in this setting enhances neonatal outcome without increasing the risk of perinatal infection. It is not clear that tocolysis in the setting of preterm PROM remote from term reduces infant morbidity. When preterm PROM occurs near term, particularly if fetal pulmonary maturity is evident, the patient is generally best served by expeditious delivery.

This article has been cited by other articles:

				S. E. CALVIN and M. L. OYEN Microstructure and Mechanics of the Chorioamnion Membrane with an Emphasis on Fracture Properties Ann. N.Y. Acad. Sci., April 1, 2007; 1101(1): 166 - 185. [Abstract] [Full Text] [PDF]

				A. P. Murtha, T. Sinclair, E. R. Hauser, G. K. Swamy, W. N. P. Herbert, and R. P. Heine Maternal Serum Cytokines in Preterm Premature Rupture of Membranes Obstet. Gynecol., January 1, 2007; 109(1): 121 - 127. [Abstract] [Full Text] [PDF]

				G. G. Briggs and S. R. Wan Drug therapy during labor and delivery, part 1. Am. J. Health Syst. Pharm., June 1, 2006; 63(11): 1038 - 1047. [Abstract] [Full Text] [PDF]

				D. Kumar, W. Fung, R. M. Moore, V. Pandey, J. Fox, B. Stetzer, J. M. Mansour, B. M. Mercer, R. W. Redline, and J. J. Moore Proinflammatory Cytokines Found in Amniotic Fluid Induce Collagen Remodeling, Apoptosis, and Biophysical Weakening of Cultured Human Fetal Membranes Biol Reprod, January 1, 2006; 74(1): 29 - 34. [Abstract] [Full Text] [PDF]

				S. Oger, C. Mehats, E. Dallot, D. Cabrol, and M.-J. Leroy Evidence for a Role of Phosphodiesterase 4 in Lipopolysaccharide-Stimulated Prostaglandin E2 Production and Matrix Metalloproteinase-9 Activity in Human Amniochorionic Membranes J. Immunol., June 15, 2005; 174(12): 8082 - 8089. [Abstract] [Full Text] [PDF]

				A. Spinillo, L. Montanari, P. Sanpaolo, C. Bergante, A. Chiara, and E. Fazzi Fetal Growth and Infant Neurodevelopmental Outcome After Preterm Premature Rupture of Membranes Obstet. Gynecol., June 1, 2004; 103(6): 1286 - 1293. [Abstract] [Full Text] [PDF]