Clinical management of premature rupture of membranes.
Premature rupture of membranes (PROM) is a common obstetric occurrence; yet, the management of a patient who presents with PROM is controversial. This article reviews the etiology of PROM, describes the evaluation of a patient who presents with PROM, and enumerates the pitfalls inherent in making the diagnosis. Research suggests that an expectant approach to PROM at term is preferable to immediate induction. The use of PGE2 gel is an option for women who have unfavorable cervices. Clinical management of preterm premature rupture of membranes (PPROM) is generally expectant, with controversies surrounding the use of amniocentesis, corticosteroids, and tocolytics. Each of these topics is reviewed and current research summarized.
King
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Department of Obstetrics and Gynecology and Reproductive Sciences, University of California at San Francisco.
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000649:Amniocentesis; D002985:Clinical Protocols; D003663:Decision Trees; D015232:Dinoprostone / Q000627:therapeutic use; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000628:therapy*; D006801:Humans; D007751:Labor, Induced; D009721:Nurse Midwives; D011247:Pregnancy; D012307:Risk Factors; D015149:Tocolytic Agents / Q000627:therapeutic use
D000305:Adrenal Cortex Hormones; D015149:Tocolytic Agents; D015232:Dinoprostone