Antenatal Monitoring After Preterm Prelabor Rupture of Membranes

PPROM is a major cause of maternal and perinatal mortality. Given the high risk of morbidity associated with this complication, admission and antepartum monitoring are used to minimize adverse maternal and fetal outcomes. At this time, inpatient antenatal monitoring includes monitoring of maternal vitals and serial examination for signs of infection or placental abruption and daily assessment of fetal status with NSTs. Ultrasound is used to evaluate fetal growth but the utility of Doppler has not been found to be of clear benefit. There is no evidence that bed rest during these admission prolongs latency to delivery or decreases maternal or perinatal morbidity. It is important that providers maintain a high level of suspicion and concern for signs of worsening maternal or fetal status during these admissions that would prompt immediate delivery. Antepartum monitoring of maternal and fetal status is used to determine when delivery should be initiated.