The pathophysiology of premature rupture of the membranes.
Premature rupture of the membranes (PROM) is the condition in which the chorioamnion is disrupted before the onset of labor. This condition creates a dilemma for the practicing obstetrician, because once the membranes have broken the risk of fetal or maternal infection, or both, increases. Preterm PROM adds to this management challenge, mainly because of the added problem of prematurity. Although the epidemiology of PROM has been well defined, the exact etiology has yet to be understood. However, using the associated clinical risk factors of PROM, researchers in this field have contributed to our understanding of the causes. Various mechanisms have been proposed, including mechanical, as well as infectious or inflammatory processes. The purpose of this article is to review the various proposed mechanisms of PROM. Maternal risk factors for PROM are presented, mainly to place into context the current literature involving both in-vitro and in-vivo research. It is apparent that a single pathophysiologic mechanism is not responsible for all cases of PROM, but rather a combination of processes is in operation.
Kelly
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Department of Reproductive Medicine, University of California at San Diego Medical Center, USA.
D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000209:etiology* / Q000503:physiopathology; D006801:Humans; D011247:Pregnancy; D012307:Risk Factors