What is the prognosis of premature preterm rupture of membranes (PPROM) in the second trimester?

Updated: Oct 05, 2018
  • Author: Allahyar Jazayeri, MD, PhD, FACOG, DACOG, FSMFM; Chief Editor: Carl V Smith, MD  more...
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Midtrimester (13-26 wk) PPROM has a poor prognosis, although more recent studies have reported better outcome. Expectant management may be appropriate in select patients who are well informed and educated about the risks and the dismal prognosis for the neonate. Delivery is also appropriate when the mother is concerned about her own risks, especially when PPROM has occurred prior to 20 weeks' gestation. Incomplete abortion may be the appropriate term for the condition, as products of conception (the amniotic fluid) have passed the cervical opening and into the vagina in these cases. Other heroic measures such as amnioinfusion, tocolysis, and cervical plug to seal the membranes are unproven and should be considered in research protocols.

Survival varies with gestational age at diagnosis (from 12% when diagnosed at 16-19 wk, to as much as 60% when diagnosed at 25-26 wk). [17] Until viability, maternal safety should be the primary concern.

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