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n Obstetrics and Gynaecology Forum - PPROM - reassembling an approach : review
Preterm prelabour rupture of membranes (PPROM) is a condition that has posed challenges in definition, etiology and management. It can be defined as the spontaneous rupture of membranes, at least one hour before the onset of uterine activity, occurring from 24 to 37 completed weeks (259 days).
The incidence of PPROM ranges between 2-12% in current literature and the occurrence of PPROM as a complication in preterm labour is estimated at 40 - 45% across the globe.
Up to 36% of woman with PPROM have a positive culture of the amniotic fluid adding chorio-amnionitis (often present in the sub-clinical form) to the risk profile in these patients as both a cause and/or consequence of PPROM.
Within the current literature there is a spectrum of articles addressing the areas of controversy such as timing of delivery as well as the use of tocolytics, antibiotics and/or corticosteroids.
This review article aims to give an overview of the general management of PPROM as well as address management options in the so called "very early" (pre-viable, <24 weeks) and "late preterm" (>34 weeks) cases.
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