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
  • prolongs pregnancy
  • 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
  • penicillins &/or macrolide antibiotics
  • 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
  • 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

More general terms

• amniotic membrane rupture
• complications of labor & delivery

Database

• OMIM: https://mirror.omim.org/entry/610504