title: [Rupture of membranes: pathophysiology, diagnosis, consequences and management].
abstract: Rupture of membranes (ROM) depends on mechanical stretch, extracellular matrix components imbalance and increased apoptosis. It occurs in 2 to 3% of all pregnancies before 37 weeks' gestation (WG) and in up to 10% at term. Main consequences are labor induction and risk of maternal-fetal infection. ROM is associated with one third of preterm births and about 20% of perinatal mortality. This review deals with recent knowledge concerning ROM including diagnosis and management. In many cases, ROM is easily identified by clinical examination. In other cases, the use of vaginal pH appears to be less efficient than the use of immunochromatographic strips based on IGFBP-1 or PAMG-1 detection. Before 34WG, conservative management consists in in utero transfer, antibioprophylaxis and corticosteroids. After 37WG, delivery is the most appropriate option. Between 34 and 37WG, recent studies demonstrate that induction of labour does not improve pregnancy outcomes. Therefore, expectant management can be the first option between 34 and 37WG when no active infection is suspected especially in case of unfavourable cervix.
authors: R2D2-EA7281, faculté de médecine, université d'Auvergne, place Henri-Dunant, 63000 Clermont-Ferrand, France.
authors: L
authors: L
authors: Blanchon
authors: M
authors: M
authors: Accoceberry
authors: C
authors: C
authors: Belville
authors: A
authors: A
authors: Delabaere
authors: C
authors: C
authors: Prat
authors: D
authors: D
authors: Lemery
authors: V
authors: V
authors: Sapin
authors: D
authors: D
authors: Gallot
mesh_terms: D000653:Amniotic Fluid / Q000737:chemistry; D005321:Extraembryonic Membranes / Q000473:pathology / Q000503:physiopathology; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000175:diagnosis* / Q000503:physiopathology* / Q000628:therapy; D005865:Gestational Age; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007231:Infant, Newborn; D018970:Insulin-Like Growth Factor Binding Protein 1 / Q000032:analysis; D007751:Labor, Induced; D016104:Oligohydramnios / Q000209:etiology / Q000503:physiopathology; D054238:Perinatal Mortality; D011247:Pregnancy; D011256:Pregnancy Outcome; D047928:Premature Birth / Q000209:etiology; D011934:Reagent Strips
chemical_list: C032231:IGFBP1 protein, human; D018970:Insulin-Like Growth Factor Binding Protein 1; D011934:Reagent Strips