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Modifications to selective conservative management in preterm premature rupture of the membranes
1Department of Obstetrics & Gynecology, University of Aberdeen, Foresterhill, United Kingdom.
Selective conservation in preterm premature rupture of the membranes (PPROM) reduces risks of infection and pulmonary hypoplasia associated with expectant management by delivering those at greatest risk, while permitting continuation of pregnancy in the remainder. Although patient selection has traditionally been a clinical decision, more accurate criteria are now available. The role of biochemical, biophysical and microbiological predictors of chorioamnionitis and fetal pulmonary status in PPROM is reviewed, and the resultant modifications to selective conservative management discussed.
Selective conservation in preterm premature rupture of the membranes (PPROM) reduces risks of infection and pulmonary hypoplasia associated with expectant management by delivering those at greatest risk, while permitting continuation of pregnancy in the remainder. Although patient selection has traditionally been a clinical decision, more accurate criteria are now available. The role of biochemical, biophysical and microbiological predictors of chorioamnionitis and fetal pulmonary status in PPROM is reviewed, and the resultant modifications to selective conservative management discussed.