Preterm rupture of membranes at 28 weeks – Management

• In women with preterm PROM remote from term, 50% will go into labor within 24 to 48 hours and 70% to 90% within 7 days. Women with preterm PROM at 24 to 28 weeks of gestation are likely to have a longer latency period than those with preterm PROM closer to term.
• Degree of oligohydramnios. The more severe the degree of oligohydramnios, the shorter the latency period.
• Severe oligohydramnios may represent a larger hole in the membranes or evidence of early fetal compromise with diminished
  urine output
• Digital cervical examinations also cause an average nine-day decrease in the latent period. Therefore do not do digital examination

• Sonographic myometrial thickness. Evidence of excessive thinning of the myometrium in nonlaboring women with preterm PROM ( 12 mm) as measured by transabdominal ultrasound has been associated with a shorter latency interval
• Evidence of pregnancy complications (such as intra-amniotic infection, placental abruption, or active labor) or nonreassuring fetal testing (previously referred to as fetal distress) will lead to early delivery and a shortened latency interval.

The fetal membranes serve as a barrier to ascending infection. Once the membranes rupture, both the mother and fetus are at risk of infection and of other complications.