Preterm Premature Rupture of Membranes

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Preterm Premature Rupture of Membranes
A complication of pregnancy that is often seen in obstetrical triage is premature rupture of membranes, according to Friedman (2013). Premature rupture of membranes (PROM) is a condition in which the membranes spontaneously rupture before the onset of active labor. Preterm premature rupture of membranes (PPROM) is PROM before 37 weeks gestation (Friedman, 2013). According to the American College of Obstetrics and Gynecology (2009), 3% of all pregnancies present with PPROM, including approximately 1/3 of all preterm births. African Americans are shown to be 2 times more likely to experience PPROM than other ethnicities, however, over the last 10 years there has been a downward trend of PPROM in singleton gestations with both African Americans and Caucasians (Mercer, 2010). Although rare, and found in less than 5% of cases, fluid loss can cease and be restored due to spontaneous sealing of the membranes (Mercer, 2010).
Etiology of PPROM is not definitive, but according to Ward and Hisley, it is thought to be a result of weakening due to one or more of the following: stress of contractions, intrauterine infection, inflammation or other conditions that would result in an increase in intrauterine pressure. A 2014 study proposed a correlation between bacteria and the thinning and premature rupture of membranes (Fortner, et al., pp. 1-10). The 2014 study states:
Fetal chorion was uniformly thinner at rupture sites compared to distant sites. In PPROM fetal chorion, we demonstrated pronounced global thinning. Although cause or consequence is uncertain, bacterial presence is greatest and inversely correlated with chorion thinning among PPROM subjects. (Fortner, et al., 2014, p. 9)
A number of ris...

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...and Gynecology. (2009, December 31). Clinical Management Guidelines for Obstetrician-Gynecologists. ACOG Compendium of Selected Publications , pp. 281-293.
Fortner, K. B., Grotegut, C. A., Ransom, C. E., Bentley, R. C., Feng, L., Lan, L., et al. (2014). Bacteria Localization and Chorion Thinning among Preterm Premature Rupture of Membranes. PLOS ONE , 9 (1), 1-10.
Friedman, A. (2013). Chapter 14: Preterm Premature Rupture of Membranes. In D. J. Angelini, D. (. LaFontaine, D. J. Angelini, & D. LaFontaine (Eds.), Obstetric Triage and Emergency Care Protocols (pp. 129-135). New York, New York: Springer Publishing.

Mercer, B. M. (2010). Preterm Premature Rupture of Membranes. In V. Berghella, Preterm Birth: Prevention and Management (pp. 217-231). Philidelphia: Wiley-Blackwell.
Ward, S. L., & Hisley, S. M. (2009). Maternal Child Nursing Care. Washington: FA Davis.

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