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

J Gynecol Obstet Biol Reprod (Paris). 2008 Oct;37(6):568-78. doi: 10.1016/j.jgyn.2007.11.031. Epub 2008 May 16.
[Article in French]

Abstract

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 labor, 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.

Publication types

  • English Abstract
  • Review

MeSH terms

  • Abruptio Placentae / etiology*
  • Amniotic Fluid / chemistry
  • Biomarkers / blood
  • Chorioamnionitis / etiology*
  • Female
  • Fetal Distress / etiology*
  • Fetal Membranes, Premature Rupture / diagnosis*
  • Fetal Membranes, Premature Rupture / immunology
  • Fetal Monitoring*
  • Humans
  • Interleukin-6 / blood
  • Obstetric Labor, Premature / etiology*
  • Pregnancy
  • Risk Factors

Substances

  • Biomarkers
  • Interleukin-6