Preterm Labor and Preterm Premature Rupture of Membranes (PPROM)

📌𝐅𝐨𝐥𝐥𝐨𝐰 𝐨𝐧 𝐈𝐧𝐬𝐭𝐚𝐠𝐫𝐚𝐦 :-   / drgbhanuprakash  

Preterm Labor and Preterm Premature Rupture of Membranes (PPROM)

Preterm labor
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Preterm labor occurs when regular contractions result in the opening of your cervix after week 20 and before week 37 of pregnancy.

Preterm labor can result in premature birth. The earlier premature birth happens, the greater the health risks for your baby. Many premature babies (preemies) need special care in the neonatal intensive care unit. Preemies can also have long-term mental and physical disabilities.

The specific cause of preterm labor often isn't clear. Certain risk factors might increase the chance of preterm labor, but preterm labor can also occur in pregnant women with no known risk factors.
Signs and symptoms of preterm labor – Early signs and symptoms of both preterm and term labor are nonspecific and include: menstrual-like cramping; mild, irregular contractions; low back ache; pressure sensation in the vagina; vaginal discharge of mucus, which may be clear, pink, or slightly bloody (ie, mucus plug, bloody show)

Complications of preterm labor include delivering a preterm baby. This can pose a number of health concerns for your baby, such as low birth weight, breathing difficulties, underdeveloped organs and vision problems. Children who are born prematurely also have a higher risk of cerebral palsy, learning disabilities and behavioral problems.

Preterm Premature Rupture of Membranes (PPROM)
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Preterm prelabor rupture of membranes (PPROM) refers to rupture of fetal membranes prior to onset of labor in pregnancies less than 37+0 weeks. It occurs in 3 percent of pregnancies and is responsible for one-third of preterm births.

Risk factors – Genital tract infection, a history of PPROM in a previous pregnancy, antepartum bleeding, and cigarette smoking have a particularly strong association with PPROM. PPROM in a previous pregnancy is associated with at least a threefold increase in risk of PPROM in the subsequent pregnancy.

Diagnosis – The diagnosis of PPROM is clinical, based on visualization of amniotic fluid coming out of the cervical canal/pooling in the posterior vaginal fornix of a patient who presents with a history of leaking fluid.

Cessation of fluid leakage is rare, except in patients with PPROM related to amniocentesis. Sealing of membranes is associated with a more favorable prognosis. (See 'Clinical course' above.)

•The duration of the latency period (ie, time from PROM to delivery) inversely correlates with gestational age at membrane rupture; however, the majority of pregnancies with PPROM deliver within one week of membrane rupture. (See 'Clinical course' above.)

•In the absence of spontaneous labor, complications that should prompt delivery include chorioamnionitis, placental abruption, and cord prolapse or compromise (eg, indicated by recurrent variable decelerations). Induction of labor is the usual approach for expectantly managed pregnancies ≥ 34 weeks of gestation.

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