RCOG

This information is for you if you have been offered a myomectomy or hysterectomy using morcellation.

This guideline comprises recommendations relating to the diagnosis, assessment, care and timing of birth of women presenting with suspected PPROM from 24+0 to 36+6 weeks of gestation. It also addresses care in a subsequent pregnancy.

1. Key recommendations (01:07)

2. Background and scope (03:35)

3. Identification and assessment of evidence (04:45)

4. Diagnosis (05:27)

4.1 How is the diagnosis of PPROM made? (05:30)

5. Assessment (10:54)

5.1 What is required antenatally to identify infection? (10:58)

5.2 Should neonatologists be included in the woman's care? (15:10)

6. Management (16:58)

6.1 Should antibiotics be given? (17:00)

6.2 What is the role of antenatal corticosteroids? (20:09)

6.3 What is the role of magnesium sulfate for neuroprotection of the baby? (25:30)

6.4 Should tocolytic agents be used? (28:17)

6.5 Can women be monitored at home? (30:22)

6.6 Is there a role for amnioinfusion in PPROM? (35:35)

6.7 Should women with PPROM be offered emotional support? (37:34)

7. Birth (39:02)

7.1 When is the appropriate time to deliver the baby? (39:05)

8. Care in a subsequent pregnancy following PPROM (44:26)

8.1 Who should care for a the woman in a subsequent pregnancy? (44:32)

9. Recommendations for future research (46:45)

10. Auditable topics (47:49)

Disclosures of interest (49:18)

Funding (49:35)

Supporting information (50:13)

References (51:03)

When your waters break prematurely by Royal College of Obstetricians and Gynaecologists

Outpatient hysteroscopy by Royal College of Obstetricians and Gynaecologists

Placenta praevia, placenta accreta and vasa praevia by Royal College of Obstetricians and Gynaecologists

Endometriosis by Royal College of Obstetricians and Gynaecologists

Cervical Stitch by Royal College of Obstetricians and Gynaecologists

Managing premenstrual syndrome (PMS) by Royal College of Obstetricians and Gynaecologists

Treatment for symptoms of the menopause by Royal College of Obstetricians and Gynaecologists

Group B Streptococcus (GBS) in Pregnancy and Newborn Babies by Royal College of Obstetricians and Gynaecologists