Preterm prelabour rupture of membranes (PPROM) ⚠️ 🤰
🧠 Clinical mechanism: Rupture of membranes before labour and before 37 weeks increases ascending infection, cord prolapse and premature birth risk.
🔎 Recognise
- Fluid leakage, changed discharge, fever or contractions; document timing, colour and odour of fluid and fetal movements.
🛟 First assessment and action
- Urgent maternity review; assess maternal temperature, pulse, uterine tenderness and fetal wellbeing; minimise unnecessary vaginal examinations.
🧪 Investigations and reassessment
- NICE recommends sterile speculum examination for pooling; targeted vaginal fluid tests if pooling not seen. Check infection using combined clinical/biochemical/fetal findings.
⚠️ Pitfall / escalation
- Do not use nitrazine to diagnose PPROM. Avoid co-amoxiclav for PPROM prophylaxis; antibiotic and steroid choices require the obstetric pathway.
UK reference: Primary NHS/NICE/RCOG/GMC source.
Editorial draft, 7 November 2026: targeted source-supported educational summary, NOT independent consultant/pharmacist verification or a treatment protocol. Follow up-to-date BNF, NICE and local NHS pathways.
Related: Labour and Complications · Suspected neonatal infection — first assessment 🚨 👶