Diagnostic Modalities in Premature Rupture of Membranes

Premature Rupture of Membranes (PROM) is defined as rupture of membranes prior to onset of labor. It can occur at any gestational week. PROM greater than 24 hours is referred as prolonged PROM and carries risk of ascending infection (1). PROM occurs in 8%-10% of all term pregnancies and in 2%-4% of all preterm singleton pregnancies (1,2). The most important maternal risk is intrauterine infection that increases with the time till onset of labor. Primary fetal risks associated with PROM include compression of umbilical cord secondary to oligohydramnios and ascending infection. Preterm PROM carries four-fold increased risk of fetal mortality, while there is a three-fold increase in risk of morbidity including intraventricular hemorrhage and respiratory distress syndrome in addition to ascending infection (1-3). In order to prevent all these complications, early and certain diagnosis of PROM is important in terms of performing intervention to minimize adverse outcomes. On the contrary, a false positive diagnosis causes unnecessary hospitalization, obstetric intervention, treatments such as steroids and even preterm induction of labor (1,2,4,5).