Premature rupture of membranes

Prenatal (premature) rupture of membranes (PROM) is defined as rupture of fetal membranes before the onset of labor or regular uterine contractions. PROM can lead to serious complications such as uterine cavity infection, umbilical cord compression, oligohydramnios, fetal malpresentation, umbilical cord prolapse, preterm delivery, fetal asphyxia and death. Initial evaluation of all term pregnancies with suspected PROM should include confirmation of membrane rupture and assessment of maternal and fetal well-being. Immediate initiation of labor is recommended in term pregnant women with PROM. Compared with expectant management, induction of labor is associated with a reduction in maternal and possibly neonatal infection and lower treatment costs without an increase in cesarean delivery. Induction with oxytocin is recommended. Oxytocin is as effective as prostaglandins, easier to titrate and may be less expensive depending on the preparation. Balloon catheter use is not recommended for cervical ripening in PROM.