PREMATURE RUPTURE OF

THE MEMBRANE

Retnayu Pradanie, S.Kep., Ns

18/03/09
AMNION
The amnion at term is a tough and
tenacious but pliable membrane.
It is the innermost fetal membrane and
is contiguous with amnionic fluid.
This particular avascular structure
occupies a role of incredible
importance in human pregnancy.
Definition of PROM…
Spontaneous rupture of the fetal membranes
that occurs before 37 completed weeks and
before the onset of labor.
Primipara cervix dilatation < 3 cm
Multipara cervix dilatation < 5 cm
Predisposing factors:
Uterus hypermotility that can be caused by
pyelonefritis, systisis, cervisitis, vaginitis
etc.
Abnormality of the membrane (very thin)
Infections (amnionitis, chorioamnionitis)
Multipara, malposisi, disproporsi, cervix
incompeten
Artificial PROM (Too early amniotomy)
Diagnosis of ruptured membranes
a sterile speculum examination to visualize
gross vaginal pooling of amnionic fluid,
from the cervical canal
Inspections for meconium, verniks caseosa,
lanugo, or bed smells of the amnion if
infections occurs
Nitrazine test: the colour’s change into blue
Ultrasonographic examination
PROM Effects
To Fetus
Infection of the fetus caused by intrauterin
infections Fetal Distress, asfixia, premature
birth, IUFD

To Mother
Intranatal until puerperium Infections, Dry
labour, Fatigue, atonia uteri, HPP
Management of PROM
Not viable (≤ 36 weeks):
Bed rest, Broad-spectrum parenteral antimicrobials,
spasmolitics and roborantia
Fetal heart rate and uterine activity are monitored for
cord compression, fetal compromise, and early labor.
For pregnancies less than 32 weeks, betamethasone
(two 12-mg doses intramuscularly 24 hours apart) or
dexamethasone (5 mg intramuscularly every 12 hours
for four doses) is given.
If the fetal status is reassuring, and if labor does not
ensue, the woman is usually transferred to an
antepartum unit and observed for labor, infection, or
fetal jeopardy.
Management of PROM
Viable (> 36 weeks)
Inductions of labour 6-12 hours after lag
phase
a parenteral antimicrobial is given for
prevention of infection.
if labor does not begin spontaneously after
induction Cesarean delivery is performed for
indications failed induction of labor.
Thank you…..