What is preterm premature rupture of membranes (PPROM)?

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What is PPROM?

Preterm Premature Rupture of Membranes (PPROM) is when the amniotic sac breaks open before labor starts and before 37 weeks of pregnancy. 1

Breaking It Down Simply

PPROM involves two key components that distinguish it from normal delivery:

  • "Preterm" means it happens before 37 weeks of pregnancy (before the baby is full-term) 1
  • "Premature rupture" means the water breaks before labor contractions begin 1

Think of it as your water breaking too early—both too early in the pregnancy timeline and too early in the labor process.

Why This Matters

The majority of women with PPROM will deliver within 7 days after their water breaks. 1

This condition carries significant risks for both mother and baby:

  • For mothers: Risk of serious infections (chorioamnionitis occurs in 38% with expectant management), bleeding, and in rare cases maternal death 2
  • For babies: The earlier PPROM occurs, the higher the risk of death and serious complications from prematurity, including lung problems, brain bleeding, and infections 2

How Common Is It?

  • PPROM complicates approximately 0.4-0.7% of all pregnancies when it occurs in mid-trimester 3
  • It accounts for about one-third of all preterm births 4, 5

Categories Based on Timing

PPROM severity depends heavily on when it occurs:

  • Previable PPROM: Before the baby could survive outside the womb (typically before 24 weeks) 1
  • Periviable PPROM: During the borderline period when survival is possible but with high risk of death or severe problems (typically 20-25 weeks) 1
  • Later PPROM: Between 24-37 weeks, where survival rates improve significantly with each additional week 2

The gestational age at which PPROM occurs and the amount of remaining amniotic fluid are the most important factors determining whether the baby will survive. 2

References

Guideline

Preterm Premature Rupture of Membranes

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Guideline

Management of Preterm Premature Rupture of Membranes (PPROM)

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Research

Preterm premature rupture of membranes: diagnosis, evaluation and management strategies.

BJOG : an international journal of obstetrics and gynaecology, 2005

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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