PPROM exam rule: DO NOT perform digital exam unless >34 weeks OR with strong painful contractions. Only sterile speculum exam, estimate cervical dilation visually.
Counseling stats:
- •50% of PPROM deliver in 1 week.
- •2–5% PPROM abrupt; 15–20% develop infection.
Latency antibiotics (specific regimen):
- •Ampicillin 2 gm IV q6h × 48h, then amoxicillin 500 mg PO TID × 5d.
- •Azithromycin 500 mg IV q24h × 2 doses, then 250 mg PO daily × 5d.
Steroids: BMZ 12 mg IM q24h × 2 doses (viability – 37 wks). Avoid in >34w if diabetic.
See also: Preterm Labor: Steroids, GBS, Mag Neuroprotection, Tocolysis.