Premature rupture of membranes: current concepts in diagnosis, management and prevention

SatishKumar B. Puttegowda; Chandana S. Ramakrishna; Shreyank H. Chandrashekara; Vijayalaxmi G. Sasavihalli; Ravindra B. Nagarajappa

doi:10.18203/2320-1770.ijrcog20263481

Authors

SatishKumar B. Puttegowda Department of Pharmacy Practice, Sri Adichunchanagiri College of Pharmacy, Adichunchanagiri University, B. G. Nagara, Karnataka, India https://orcid.org/0000-0001-9475-0969
Chandana S. Ramakrishna Department of Pharmacy Practice, Sri Adichunchanagiri College of Pharmacy, Adichunchanagiri University, B. G. Nagara, Karnataka, India https://orcid.org/0009-0007-2583-0800
Shreyank H. Chandrashekara Department of Pharmacy Practice, Sri Adichunchanagiri College of Pharmacy, Adichunchanagiri University, B. G. Nagara, Karnataka, India https://orcid.org/0009-0005-7750-413X
Vijayalaxmi G. Sasavihalli Department of Obstetrics and Gynaecology, Adichunchanagiri Hospital and Research Centre, Adichunchanagiri University, B. G. Nagara, Karnataka, India https://orcid.org/0009-0006-1895-7371
Ravindra B. Nagarajappa Department of Pharmacy Practice, Sri Adichunchanagiri College of Pharmacy, Adichunchanagiri University, B. G. Nagara, Karnataka, India https://orcid.org/0000-0003-0273-6022

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20263481

Keywords:

Preterm premature rupture of membranes, Diagnosis, Management, Corticosteroids, Antibiotic therapy

Abstract

Premature rupture of membranes (PROM) is an obstetric complication associated with adverse maternal and neonatal outcomes. Preterm PROM (PPROM) contributes substantially to preterm birth and unfavorable perinatal outcomes. This narrative review summarizes current evidence regarding the risk factors, diagnosis, management, and prevention of PROM and PPROM. A literature search was conducted using PubMed, Scopus, and Google Scholar for relevant publications from 2000 to 2026. Relevant clinical trials, systematic reviews, and clinical guidelines were included. Diagnosis of PROM requires clinical evaluation with the help of biochemical markers such as placental alpha microglobulin-1 (PAMG-1) and insulin-like growth factor binding protein-1 (IGFBP-1). The management strategies are based on gestational age and include antibiotic therapy, antenatal corticosteroids, magnesium sulfate for fetal neuroprotection, and careful assessment of maternal and fetal well-being. Early recognition, accurate diagnosis, and evidence-based management are essential for improving maternal and neonatal outcomes associated with PROM and PPROM. Management should be individualized according to gestational age and maternal and fetal clinical status, with appropriate use of antibiotics, antenatal corticosteroids, magnesium sulfate for fetal neuroprotection, and close monitoring when indicated. Preventive strategies addressing modifiable risk factors may further contribute to reducing the burden of PROM and PPROM.

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