How is PPROM confirmed?

Classic triad: pooling in posterior fornix, positive nitrazine test (pH >6.5, false positives with blood/semen/vaginitis), positive ferning on drying of vaginal fluid. AmniSure (PAMG-1) and Actim PROM (IGFBP-1) are rapid immunoassay alternatives with higher accuracy.

What antibiotics are used in PPROM latency therapy?

NICHD MFMU regimen: ampicillin + erythromycin IV ×48h, then amoxicillin + erythromycin po ×5 days (total 7 days). Prolong latency and reduce chorioamnionitis, neonatal sepsis. Amoxicillin-clavulanate (Augmentin) avoided due to increased NEC risk.

When to deliver in PPROM?

PPROM at ≥34 weeks: deliver. At 24-33+6 weeks: expectant management with steroids, antibiotics, and GBS prophylaxis. At <24 weeks (periviable): counsel on prognosis, option for expectant management or delivery. At ≥20 weeks with PPROM: high fetal mortality risk from pulmonary hypoplasia.

PPROM Diagnosis and Latency Period Calculator

Diagnose and manage preterm premature rupture of membranes (PPROM) at 18-36+6 weeks. Pooling + ferning + nitrazine confirms diagnosis. Estimate latency period: median 5-7 days at 28-31 weeks; delivery within 1 week of PPROM in 50% of cases.

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