Complications and monitoring of the latency period after a preterm premature rupture of the fetal membranes: Literature review

Preterm premature rupture of the membranes (PPROM) begins a high-risk period for both mother and fetus. This literature review updates the knowledge on latency-period complications and proposed monitoring strategies. Four latency-period complications are described: spontaneous onset of tabor, infection (chorioamnionitis), abruptio placentae, and fetal, distress which can be linked to umbilical cord prolapse. Admittedly, the infection/inflammation process plays a key role during the latency period. Conservative management of PPROM is recommended and is associated with significant pregnancy prolongation. This strategy allows a gain in fetal maturity, but increases the risk of complications. The prediction of infection seems to be essential; classical markers, such as blood count and reactive C protein are not very effective. New markers have been tested, with IL-6 appearing to be one of the best infection markers. Fetal pulmonary maturity can be evaluated with a rapid screening test and can yield arguments for the management strategy. (C) 2007 Publie par Elsevier Masson SAS.