Preterm Premature Rupture of Membranes: A Review of 3 National Guidelines

Importance Preterm premature rupture of membranes (PPROM) is a major cause of perinatal mortality and morbidity. Objective The aim of this study was to compare recommendations from published national guidelines for pregnancies complicated with PPROM. Evidence Acquisition A descriptive review of 3 national guidelines on PPROM was performed: the Royal College of Obstetricians and Gynaecologists on “Preterm Prelabour Rupture of Membranes,” the American College of Obstetricians and Gynecologists on “Premature Rupture of Membranes,” and the Society of Obstetricians and Gynaecologists of Canada on “Antibiotic Therapy in Preterm Premature Rupture of the Membranes.” Guidelines were compared in the diagnosis and management of PPROM. Recommendations and strength of evidence were reviewed based on each guideline's method of reporting. The references were compared with regard to their total number, total number of randomized controlled trials, Cochrane reviews, and systematic reviews/meta-analyses cited. Results The variations stated on the guidelines reflect the heterogeneity of the literature contributing to the guidelines and challenges of diagnosing and managing cases of PPROM. Conclusions An improved international guideline may improve safety and outcomes in pregnant women with PPROM. Target Audience Obstetricians and gynecologists, family physicians. Learning Objectives After completing this activity, the learner should be better able to assess the aspects on diagnosis of preterm premature rupture of membranes, analyze the available regimens for the management of cases with preterm premature rupture of membranes, and identify the appropriate time of delivery in cases of preterm premature rupture of membranes.