Pre-term pre-labour amniorrhexis

In pregnancies complicated by pre-term pre-labour aminorrhexis, there is a risk of intra-uterine infection, which is associated with maternal and perinatal mortality and morbidity. The causes of neonatal death in pregnancies with aminorrhexis are prematurity, pulmonary hypoplasia and sepsis. In the management of pregnancies with pre-term pre-labour amniorrhexis, it is essential to distinguish between those with and without intra-uterine infection. If there is no infection at presentation, it is unlikely that this will develop, and in such cases there is no benefit from hospitalization, bed rest, prophylactic tocolytics or antibiotics. The group with evidence of intra-uterine infection go into spontaneous labour within a few days of amniorrhexis; in this group, the main determinant for the appropriate management is the gestational age at amniorrhexis.