ACOG PB139 Premature Rupture of
Membranes UPDATED ACTUAL
Questions and CORRECT Answers
How common is preterm deliver in the USA? - CORRECT ANSWER - 12% of all births
How common is PROM? - CORRECT ANSWER - 3%
What is the main issue with management of PROM? - CORRECT ANSWER -
Prematurity vs Risk of Expectant Management (Infection, Abruption, Umbilical cord accident)
Definition of PROM - CORRECT ANSWER - Rupture of membranes before the onset of
labor
Definition of PPROM - CORRECT ANSWER - Membrane rupture before labor and
before 37 weeks of gestation
What causes rupture of membranes? - CORRECT ANSWER - Normal weakening of
membranes, shearing forces from uterine contractions.
Risk factors for PROM? - CORRECT ANSWER - Intraamniotic infection, hx of PROM,
Shortened cervix, 2nd/3rd trimester bleed, low BMI, low SES, Cigarette smoking, illicit drug use
How often is PROM in term pregnancies? - CORRECT ANSWER - 8%. Generally
followed by onset of labor.
Consequence of term PROM? - CORRECT ANSWER - Intrauterine infection, increases
with duration of membrane rupture
, How many patients deliver regardless of obstetric managment of PPROM? How many between
2-5 weeks? - CORRECT ANSWER - 50%, 70-80%
Latency after membrane rupture is _____ correlated with GA at time of PPROM. - CORRECT
ANSWER - Inversely
Clinically evident intraamniotic infection occurs in ____. Post partum infection occurs in _____.
Incidence of infection is higher at _______. - CORRECT ANSWER - 15-25%
15-20%
Earlier GA
Placental abruption occurs in ____ of PPROM. - CORRECT ANSWER - 2-5%
Most common issues/risks of prematurity? - CORRECT ANSWER - Respiratory distress -
most common
Sepsis
Intraventricular hemorrhage
Necrotizing Enterocolitis
PPROM w/ intrauterine inflammation has increased risk of what comorbidity? - CORRECT
ANSWER - Neurodevelopmental impairment. Early GA associated with increased risk of
neonatal white matter damage.
How often does PROM occur prior to viability? - CORRECT ANSWER - 1%
Maternal complications from previable PROM? - CORRECT ANSWER - Intraamniotic
infection, endometritis, abruptio placentae, retained placenta. Sepsis occurs 1% of time.
How common is pulmonary hypoplasia after PROM before 24 weeks? - CORRECT
ANSWER - 10-20%. Rarely lethal with PROM subsequent to 23-24 weeks.
Membranes UPDATED ACTUAL
Questions and CORRECT Answers
How common is preterm deliver in the USA? - CORRECT ANSWER - 12% of all births
How common is PROM? - CORRECT ANSWER - 3%
What is the main issue with management of PROM? - CORRECT ANSWER -
Prematurity vs Risk of Expectant Management (Infection, Abruption, Umbilical cord accident)
Definition of PROM - CORRECT ANSWER - Rupture of membranes before the onset of
labor
Definition of PPROM - CORRECT ANSWER - Membrane rupture before labor and
before 37 weeks of gestation
What causes rupture of membranes? - CORRECT ANSWER - Normal weakening of
membranes, shearing forces from uterine contractions.
Risk factors for PROM? - CORRECT ANSWER - Intraamniotic infection, hx of PROM,
Shortened cervix, 2nd/3rd trimester bleed, low BMI, low SES, Cigarette smoking, illicit drug use
How often is PROM in term pregnancies? - CORRECT ANSWER - 8%. Generally
followed by onset of labor.
Consequence of term PROM? - CORRECT ANSWER - Intrauterine infection, increases
with duration of membrane rupture
, How many patients deliver regardless of obstetric managment of PPROM? How many between
2-5 weeks? - CORRECT ANSWER - 50%, 70-80%
Latency after membrane rupture is _____ correlated with GA at time of PPROM. - CORRECT
ANSWER - Inversely
Clinically evident intraamniotic infection occurs in ____. Post partum infection occurs in _____.
Incidence of infection is higher at _______. - CORRECT ANSWER - 15-25%
15-20%
Earlier GA
Placental abruption occurs in ____ of PPROM. - CORRECT ANSWER - 2-5%
Most common issues/risks of prematurity? - CORRECT ANSWER - Respiratory distress -
most common
Sepsis
Intraventricular hemorrhage
Necrotizing Enterocolitis
PPROM w/ intrauterine inflammation has increased risk of what comorbidity? - CORRECT
ANSWER - Neurodevelopmental impairment. Early GA associated with increased risk of
neonatal white matter damage.
How often does PROM occur prior to viability? - CORRECT ANSWER - 1%
Maternal complications from previable PROM? - CORRECT ANSWER - Intraamniotic
infection, endometritis, abruptio placentae, retained placenta. Sepsis occurs 1% of time.
How common is pulmonary hypoplasia after PROM before 24 weeks? - CORRECT
ANSWER - 10-20%. Rarely lethal with PROM subsequent to 23-24 weeks.
