Publication:

Premature rupture of membranes: current concepts in diagnosis, management and prevention

Premature rupture of membranes (PROM) is an obstetric complication associated with adverse maternal and neonatal outcomes. Preterm PROM (PPROM) contributes substantially to preterm birth and unfavorable perinatal outcomes. This narrative review summarizes current evidence regarding the risk factors, diagnosis, management, and prevention of PROM and PPROM. A literature search was conducted using PubMed, Scopus, and Google Scholar for relevant publications from 2000 to 2026. Relevant clinical trials, systematic reviews, and clinical guidelines were included. Diagnosis of PROM requires clinical evaluation with the help of biochemical markers such as placental alpha microglobulin-1 (PAMG-1) and insulin-like growth factor binding protein-1 (IGFBP-1). The management strategies are based on gestational age and include antibiotic therapy, antenatal corticosteroids, magnesium sulfate for fetal neuroprotection, and careful assessment of maternal and fetal well-being. Early recognition, accurate diagnosis, and evidence-based management are essential for improving maternal and neonatal outcomes associated with PROM and PPROM. Management should be individualized according to gestational age and maternal and fetal clinical status, with appropriate use of antibiotics, antenatal corticosteroids, magnesium sulfate for fetal neuroprotection, and close monitoring when indicated. Preventive strategies addressing modifiable risk factors may further contribute to reducing the burden of PROM and PPROM.