ACOG guidance on Prelabor Rupture of Membranes (PROM) addresses current literature especially related to management of late preterm PROM (34w0d to 36w6d). Following appropriate counseling, expectant management or delivery is appropriate. The use of ‘prelabor’ is in keeping with reVITALize terminology (see ‘Related ObG Topics’ below) and is defined as the ‘spontaneous rupture of membranes that occurs before the onset of labor’.
Clinical Considerations
It is critically important that patients are counseled on the higher rates of morbidity associated with expectant management, which may be greater than previously reported, to ensure they can make a fully informed decision regarding their care
Management
Note: There are multiple regimens in use | There is no evidence to support a single optimal regimen for latency antibiotics
Care should be individualized through shred decision making, and expectant management should not extend beyond 37 0/7 weeks of gestation
Outside the scenario of unknown GBS status, latency antibiotics are not appropriate in this setting
ACOG Practice Bulletin 217: Prelabor Rupture of Membranes
ACOG: Use of Antenatal Corticosteroids at 22 Weeks of Gestation
ACOG Practice Bulletin 831: Medically Indicated Late-Preterm and Early-Term Deliveries
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