Prelabor Rupture of Membranes

  • Practice Bulletin PB
  • Number 217
  • March 2020

ABSTRACT: Preterm birth occurs in approximately 10% of all births in the United States and is a major contributor to perinatal morbidity and mortality 1 2 3. Prelabor rupture of membranes (PROM) that occurs preterm complicates approximately 2–3% of all pregnancies in the United States, representing a significant proportion of preterm births, whereas term PROM occurs in approximately 8% of pregnancies 4 5 6. The optimal approach to assessment and treatment of women with term and preterm PROM remains challenging. Management decisions depend on gestational age and evaluation of the relative risks of delivery versus the risks (eg, infection, abruptio placentae, and umbilical cord accident) of expectant management when pregnancy is allowed to progress to a later gestational age. The purpose of this document is to review the current understanding of this condition and to provide management guidelines that have been validated by appropriately conducted outcome-based research when available. Additional guidelines on the basis of consensus and expert opinion also are presented. This Practice Bulletin is updated to include information about diagnosis of PROM, expectant management of PROM at term, and timing of delivery for patients with preterm PROM between 34 0/7 weeks of gestation and 36 6/7 weeks of gestation.

Log in to read more

This content is only available to members and subscribers.

Log In

Nonmembers: Subscribe now to access exclusive ACOG Clinical content, including:

ACOG Clinical is designed for easy and convenient access to the latest clinical guidance for patient care. Developed with members’, physicians’, and women’s health care professionals’ needs in mind, user-friendly features include:

  • Easy, advanced search function to find the most relevant guidance
  • Enhanced document presentation
  • Advanced features and functionality

You’ll find clinical content written and peer reviewed by experts and valuable information that spans guidance on the diagnosis and management of the full spectrum of obstetric and gynecological conditions and clinical management issues.

Note for Life Fellows: Annual membership dues are waived but there is a discounted annual subscription fee of $95 for access to publications such as the Green Journal, Practice Bulletins, and Committee Opinions. Individual subscriptions include print and online access. Subscribe today.