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PPROM Guidelines
PPROM Guidelines
Purpose of Policy:
Scope of Policy:
Clinical Personal
Diagnosis:
History, vaginal pool with +ferning/nitrazine, amniocentesis with indigo-carmine infusion (dye test)
Policy/guideline:
Evaluation:
If evidence of amnionitis, abruptio placenta, non-reassuring fetal status, advanced labor, or fetal
death recommend moving toward delivery with intraparum GBS prophylaxis or broad spectrum
antibiotics if amnionitis present
If the aforementioned conditions are not met, the recommendations are as follows by gestational
age:
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2. PERI-VIABLE PPROM (23.0 — 23.6 weeks)
Collect amniotic fluid (transvaginal pooling or amniocentesis) if possible for fetal lung
maturity studies.
o If testing indicates lung maturity, delivery should be considered
If no fluid is available for testing or testing is not consistent with lung
maturity, patients should be offered conservative management with
administration of antenatal corticosteroids, latency antibiotics as per
the MFMU-NIH protocol, and delivery indications as outlined above.
PRIMARY REFERENCE:
Mercer BM. Preterm Premature Rupture of the Membranes. Obstet Gynecol 2003;101:178-93.
Please see references for this review article for further details.
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