Preterm premature rupture of membranes (PPROM) is a relatively common event with great clinical significance. PPROM occurs in approximately 2-3 of pregnancies and typically leads to preterm delivery. Indeed, preterm delivery (PTD) is the major complication related to PPROM.The latency period, from amniorrhexis to the onset of labor, is generally longer at earlier gestational ages. Preterm delivery occurred within 2 days of amniorrhexis in 60-70 of patients after PPROM between 20-32 weeks gestational age and in approximately 80 of women if PPROM occurred between 33-36 weeks.1The risk of perinatal mortality related to premature rupture of membranes (PROM) and subsequent preterm delivery is inversely related to the gestational age at which membrane rupture occurs.1The risk of neonatal morbidity also varies inversely with gestational age at the time of PPROM. Potential fetal and neonatal morbidities occurring after PROM, described in more detail elsewhere in this monograph, include hyaline membrane disease, neonatal infections, umbilical cord prolapse, fetal distress, pulmonary hypoplasia, and skeletal deformities. Recognition of these potential complications has prompted consideration of several possible interventions to decrease the morbidity to at-risk fetuses. Specifically, noting the relation of these morbidities to anticipated preterm delivery after PROM justifies the consideration of tocolysis.
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