Premature Rupture of Membranes: Treatment
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Treatment of PROM depends on the stage of the patient's pregnancy. In PROM occurring at term, the mother and baby will be watched closely for the first 24 hours to see if labor will begin naturally. If no labor begins after 24 hours, most doctors will use medications to start labor. This is called inducing labor. Labor is induced to avoid a prolonged gap between PROM and delivery because of the increased risk of infection.
Preterm PROM presents more difficult treatment decisions. The younger the fetus, the more likely it may die or suffer serious permanent damage if delivered prematurely. Yet the risk of infection to the mother and/or the fetus increases as the length of time from PROM to delivery increases. Depending on the age of the fetus and signs of infection, the doctor must decide either to try to prevent labor and delivery until the fetus is more mature, or to induce labor and prepare to treat the complications of prematurity. However, the baby will need to be delivered to avoid serious risks to both it and the mother if infection is present, regardless of the risks of prematurity.
A variety of medications may be used in PROM:
- Medication to induce labor (oxytocin) may be used, either in the case of PROM occurring at term or in the case of preterm PROM and infection.
- Tocolytics may be given to halt or prevent the start of labor. These may be used in the case of preterm PROM, when there are no signs of infection. Delaying the start of labor may give the fetus time to develop more mature lungs.
- Steroids may be used to help the fetus' lungs mature early. Steroids may be given in preterm PROM if the fetus must be delivered early because of infection or labor that cannot be stopped.
- Antibiotics can be given to fight infections. Research is being done to determine whether antibiotics should be given prior to any symptoms of infection to avoid the development of infection.
— Rosalyn Carson-DeWitt, MD
