What is included in expectant management following premature rupture of membranes (PROM)?

Updated: Oct 05, 2018
  • Author: Allahyar Jazayeri, MD, PhD, FACOG, DACOG, FSMFM; Chief Editor: Carl V Smith, MD  more...
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After an initial period of continuous monitoring of fetal heart rate and uterine contractions (24-48 h), if findings are suggestive of reassuring surveillance, then the patient would be a candidate for expectant management. In general, common practice has been to place the patient on bed rest on the obstetric floor. However, the the existing data show no benefit to bed rest for any obstetric condition.  Because bed rest in pregnancy is associated with an increased chance of deep venous thrombosis, prophylaxis to reduce this risk should be instituted.

In addition, fetal monitoring should be performed at least once a day. If evidence of frequent cord compression is present as determined by moderate-to-severe variables, continuous monitoring should be reinstituted. Maternal vitals need to be monitored closely. Tachycardia and fever are both suggestive of chorioamnionitis and require careful evaluation to determine the presence of intra-amniotic infections, in which case delivery and initiation of broad-spectrum antibiotics should be promptly facilitated.

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