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    The Pathophysiology of PPROM

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    Nano Ka
    The document discusses premature rupture of membranes (PROM), which refers to when the amniotic sac breaks before the onset of labor. It describes different types of PROM including preterm PPROM (before 37 weeks), term PROM (at or after 37 weeks), and prolonged PROM (lasting over 24 hours before labor starts). Factors that can lead to preterm PPROM include inflammation/infection of the membranes, low socioeconomic status, tobacco use, and other clinical risks. PPROM occurs in about 3% of pregnancies and is a leading cause of preterm birth, which accounts for 85% of neonatal mortality and morbidity. Managing PPROM aims to minimize risks and maximize outcomes for both

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    The Pathophysiology of PPROM

    Uploaded by

    Nano Ka
    94 views2 pages
    The document discusses premature rupture of membranes (PROM), which refers to when the amniotic sac breaks before the onset of labor. It describes different types of PROM including preterm PPROM (before 37 weeks), term PROM (at or after 37 weeks), and prolonged PROM (lasting over 24 hours before labor starts). Factors that can lead to preterm PPROM include inflammation/infection of the membranes, low socioeconomic status, tobacco use, and other clinical risks. PPROM occurs in about 3% of pregnancies and is a leading cause of preterm birth, which accounts for 85% of neonatal mortality and morbidity. Managing PPROM aims to minimize risks and maximize outcomes for both

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    The document discusses premature rupture of membranes (PROM), which refers to when the amniotic sac breaks before the onset of labor. It describes different types of PROM including preterm PPROM (before 37 weeks), term PROM (at or after 37 weeks), and prolonged PROM (lasting over 24 hours before labor starts). Factors that can lead to preterm PPROM include inflammation/infection of the membranes, low socioeconomic status, tobacco use, and other clinical risks. PPROM occurs in about 3% of pregnancies and is a leading cause of preterm birth, which accounts for 85% of neonatal mortality and morbidity. Managing PPROM aims to minimize risks and maximize outcomes for both

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    94 views2 pages

    The Pathophysiology of PPROM

    Uploaded by

    Nano Ka
    The document discusses premature rupture of membranes (PROM), which refers to when the amniotic sac breaks before the onset of labor. It describes different types of PROM including preterm PPROM (before 37 weeks), term PROM (at or after 37 weeks), and prolonged PROM (lasting over 24 hours before labor starts). Factors that can lead to preterm PPROM include inflammation/infection of the membranes, low socioeconomic status, tobacco use, and other clinical risks. PPROM occurs in about 3% of pregnancies and is a leading cause of preterm birth, which accounts for 85% of neonatal mortality and morbidity. Managing PPROM aims to minimize risks and maximize outcomes for both

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    of 2

    The pathophysiology of PPROM

    Amniotic fluid is the water that surrounds your baby in the womb. Membranes or layers
    of tissue hold in this fluid. This membrane is called the amniotic sac. Often, the
    membranes rupture (break) during labor.

    Premature rupture of the membranes (PROM) is the condition in which the


    chorioamnion is disrupted before the onset of labor. This condition creates a dilemma
    for the practicing obstetrician, because once the membranes have broken the risk of
    fetal or maternal infection, or both, increases.

    Premature rupture of membranes (PROM) refers to a patient who is beyond 37 weeks'


    gestation and has presented with rupture of membranes (ROM) prior to the onset of
    labor. Preterm premature rupture of membranes (PPROM) is ROM prior to 37 weeks'
    gestation. Spontaneous premature rupture of the membranes (SPROM) is ROM after or
    with the onset of labor. Prolonged ROM is any ROM that persists for more than 24
    hours and prior to the onset of labor.

    At term, programmed cell death and activation of catabolic enzymes, such as


    collagenase and mechanical forces, result in ruptured membranes. Preterm PROM
    occurs probably due to the same mechanisms and premature activation of these
    pathways. However, early PROM also appears to be linked to underlying pathologic
    processes, most likely due to inflammation and or infection of the membranes. Clinical
    factors associated with preterm PROM include low socioeconomic status, low body mass
    index, tobacco use, preterm labor history, urinary tract infection, vaginal bleeding at any
    time in pregnancy, cerclage, and amniocentesis.

    Eighty-five percent of neonatal morbidity and mortality is a result of prematurity,


    PPROM is associated with 30-40% of preterm deliveries and is the leading identifiable
    cause of preterm delivery, PPROM complicates 3% of all pregnancies and occurs in
    approximately 150.000 pregnancies yearly in the United States. When PPROM occurs
    remote from term, significant risks of morbidity and mortality are present for both the
    fetus and the mother Thus, the physician caring for the pregnant woman whose
    pregnancy has been complicated with PPROM plays an important role in management
    and needs to be familiar with potential complications and possible interventions to
    minimize risks and maximize the probability of the desired outcome.
    Premature Rupture of Membranes (at Term)

    Premature rupture of membranes (PROM) at term is rupture of membranes prior to the


    onset of labor at or beyond 37 weeks' gestation. PROM occurs in approximately 10% of
    pregnancies, Patients with PROM present with leakage of fluid, vaginal discharge,
    vaginal bleeding, and pelvic pressure, but they are not having contractions.

    ROM is diagnosed by speculum vaginal examination of the cervix and vaginal cavity,
    Pooling of
    fluid in the vagina or leakage of fluid from the cervix, ferning of the dried fluid under
    microscopic examination, and alkalinity of the fluid as determined by Nitrazine paper
    confirm the diagnosis.

    Blood contamination of the Nitrazine paper and ferning of cervical mucus may produce
    false positive results. Pooling of fluid is by far the most accurate for diagnosis of ROM. If
    all fluid has leaked out as in early PROM, an ultrasonographic examination may then
    show absence of or very low amounts of amniotic fluid in the uterine cavity.

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