Prelabour rupture of membranes at term (PROM)

O42.0-1/O42.9

DESCRIPTION

Rupture of membranes before the onset of labour at term (>37 weeks).

A sterile speculum examination is required to visually confirm amniotic fluid draining through the cervical os.

GENERAL MEASURES

  • If PROM is followed by uterine contractions at >34 'weeks’ gestation, allow labour to proceed.
  • If the woman does not develop uterine contractions within 12 hours of PROM, commence antibiotics and transfer for induction of labour.

MEDICINE TREATMENT

Prolonged rupture of membranes >12 hours/ suspected chorio-amnionitis:

Initiate antibiotic therapy: O41.1

  • Ampicillin, IV, 1 g as a single dose.

AND

  • Metronidazole, oral, 400 mg as a single dose and refer.

Severe penicillin allergy: Z88.0

  • Azithromycin, oral, 500 mg as a single dose.

AND

  • Metronidazole, oral, 400 mg as a single dose and refer.

LoEIII

REFERRAL

Urgent

  • Suspected chorio-amnionitis (refer after starting antibiotics).
  • Prolonged rupture of membranes (>12 hours).
  • Meconium stained liquor.