PREMATURE RUPTURE

OF MEMBRANE
meaning

• pre - before

• mature - developed

• rupture - breakage

• membrane - layer
Rupture of membrane or breakage
of amniotic sac more than one hour
before the onset of labor.
overview

• uterine sac/amniotic sac

• Chorion - outer membrane

• Amnion - inner membrane
Function of Amniotic Sac

• Amniotic sac is filled with amniotic fluid, this fluid

provide protection to fetus and function as cushion of
fetus.
• Amniotic fluid allows the fetus to move freely in
uterine cavity.
Classification of Premature Rupture of
Membrane
(classified according to fetal age)

Preterm PROM
in this type of PROM.... membrane that rupture
before the 37 weeks of gestational age
Classification of Premature Rupture of
Membrane
(classified according to fetal age)

Prolonged PROM
in this type of rupture.... 24 hours have passed
between membrane rupture and onset of labor.
Classification of Premature Rupture of
Membrane
(classified according to fetal age)

Pre-viable Preterm PROM

this type of rupture occurs.... before 24 weeks of
gestational age fetus (also known as mid-trimester
PPROM)
Causes of PROM

Weakening of Extreme force of Fetal movement

membranes contraction of uterus
 RISK FACTORS
• Infection
• UTI
• STDs
• Bacterial vaginosis
• Amniotic infection
 RISK FACTORS
• Smoking during pregnancy
• Previous history of PROM
• Previous history of preterm labor
• Polyhydramnios (>2000 mL amniotic fluid)
normal AFV = 800 mL
 RISK FACTORS
• Multiple gestation or multiple pregnancy
• Hemorrhage or bleeding any time during the pregnancy
• Invasive procedures (Amniocentesis)
• Cervical insufficiency
Signs and Symptoms of
PROM

• Painless leakage of fluid from vagina

• Due to loss of fluid, fetus can be easily felt through belly
• Decreased uterine size
• Meconium present in fluid
Signs and Symptoms of
PROM

• Abdominal pain
• Fetal heart sound altered
• Gush of membrane
• Absence of steady labor contraction
Diagnostic evaluations of
PROM
• History collection
• Previous labor
• Maternal history
• Maternal illness
• Fetal movement assessment
• Fetal position
• Blood analysis
• Sterile speculum examination
Nursing Management
• Hospitalization of woman
• Evaluated for labor and fetal distress
• Evaluated for infection
• Complete bed rest
• Continuously observe the fetal movements
• Continuously observe the fetal heart sound
• Continuously assess the vital signs of the mother