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preterm premature rupture of membranes (PPROM)
Genetics:
- a functional SNP in the promoter of SERPINH1 is associated in African Americans with an increased risk for preterm premature rupture of membranes (PPROM)
Laboratory:
- urinalysis
- Genprobe for GC/chlamydia
- rapid plasma reagin (RPR) for syphilis
- HIV1 ELISA
- IDI group B streptococcus assay
- alpha-1-microglobulin in vaginal fluid (diagnosis)
Management:
- if < 32 weeks' gestation, antibiotics should be administered to women who are not in labor
a) prolongs pregnancy
b) decreases maternal & neonatal morbidity
- if > 32 weeks' gestation, administration of antibiotics is recommended if fetal lung maturity cannot be proven &/or delivery is not planned
- antibiotic regimens
a) penicillins &/or macrolide antibiotics
b) ampicillin 2 g IV every 6 hours plus erythromycin 250 mg IV every 6 hours for 48 hours, followed by amoxicillin 250 mg orally every 8 hours plus erythromycin 333 mg orally every 8 hours for 5 days
c) erythromycin 250 mg orally every 6 hours for 10 days d amoxicillin/clavulanic acid should not be used because of an increased risk of necrotizing enterocolitis in neonates
General
amniotic membrane rupture
complications of labor & delivery
Database Correlations
OMIM 610504
References
- Yudin MH et al
Antibiotic therapy in preterm premature rupture of the membranes.
J Obstet Gynaecol Can. 2009 Sep;31(9):863-7, 868-74.
PMID: 19941711