Rupture of the membranes and postpartum infection

The greatest risk of preterm prelabour rupture of membranes (PPROM) is preterm delivery. According to the Perinatal Information System of Slovenia there were 5.92% preterm deliveries in 1994. We studied 809 deliveries of less than 34 weeks of gestation in the Ljubljana Maternity, from 1992 to 1994; 33.7% of these started with PPROM. Risk factors for PPROM were conization, cerclage and use of antibiotics for any reason in current pregnancy. Amnionitis and febrile illness during labour increased with longer duration of PPROM but maternal postpartum infections did not. In neonates, more cases of lower Apgar scores after 1 and 5 min and more cases of suspected sepsis were found with the increased duration of PPROM. In Slovenia, with good facilities for transport in utero and good neonatal care, after PPROM it is best to transport the pregnant women to the third level center and then wait until labour starts or to recur to prompt delivery when maternal or fetal signs so require. From 1987 to 1993 there were 159264 deliveries in gestations equal to or over 34 weeks; 20.8% started with PROM. In our observational study we found the best results when labour was induced. There are, however, many disagreements about the management of (P)PROM.