Preterm Premature Rupture of the Membranes

Rupture of membranes before 37 weeks of GESTATION, which occurs in approximately 3% of all pregnancies and accounts for about one-third of spontaneous PREMATURE BIRTHS. Polymorphisms in the SERPINH1, MMP1, and MMP8 genes have been identified. OMIM: 610504

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Networked: 878 relevant articles (43 outcomes, 201 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1.	Rupture
2.	Infections
3.	Chorioamnionitis
4.	Preterm Premature Rupture of the Membranes
5.	Premature Obstetric Labor (Premature Labor)

Experts

1.	Kacerovsky, Marian: 50 articles (12/2022 - 01/2009)
2.	Musilova, Ivana: 39 articles (12/2022 - 01/2010)
3.	Jacobsson, Bo: 38 articles (12/2022 - 12/2007)
4.	Andrys, Ctirad: 33 articles (12/2022 - 01/2009)
5.	Menon, Ramkumar: 28 articles (01/2019 - 10/2002)
6.	Drahosova, Marcela: 22 articles (03/2021 - 01/2009)
7.	Hornychova, Helena: 21 articles (12/2022 - 01/2009)
8.	Pliskova, Lenka: 21 articles (09/2022 - 01/2009)
9.	Romero, Roberto: 21 articles (05/2021 - 11/2002)
10.	Park, Kyo Hoon: 14 articles (01/2022 - 08/2007)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Preterm Premature Rupture of the Membranes:

1.	Anti-Bacterial Agents (Antibiotics)IBA 10/01/1996 - "We recommend aggressive adjunctive antibiotic treatment to prolong pregnancy and reduce morbidity in patients with pPROM, at gestations remote from term, when a significant improvement in neonatal outcome can anticipated with expectant management." 12/01/2023 - "We selected randomized controlled trials (RCTs) that compared vaginal probiotics along with antibiotics versus antibiotics only among pregnant women who were presented with PPROM between 24 and 34 weeks of gestation. " 09/01/2022 - "This recommended antibiotic regimen for women with PPROM needs further study under a randomized clinical trial with a larger study population to evaluate its efficacy." 09/01/2022 - "In this study, we aimed to investigate which broad-spectrum antibiotic was most suitable for PPROM cases in Taiwan. " 01/01/2020 - "This was a network meta-analysis of randomized controlled trials comparing prophylactic antibiotics, or regimens of antibiotics, with each other or with placebo/no treatment, in women with PPROM. "
2.	Adrenal Cortex Hormones (Corticosteroids)IBA 06/01/1987 - "The recent reaffirmation of the National Collaborative Study and similarly designed studies that reject the efficacy of corticosteroid administration to patients with preterm premature rupture of the membranes prompted us to reevaluate patients screened for inclusion in our recently reported series. " 12/01/2020 - "Although future studies are needed to elucidate effects of antenatal corticosteroids at less than 23 weeks' gestation and a rescue course at later gestational ages after PPROM, a single course of antenatal corticosteroids is vital to optimizing neonatal outcomes after PPROM."" 04/01/2023 - "Patients were separated into three groups based on amniotic membrane status at the time of each corticosteroid administration: Group 1 (intact membranes at initial/intact membranes at rescue), Group 2 (intact membranes at initial/PPROM at rescue), and Group 3 (PPROM at initial/PPROM at rescue). " 01/01/2021 - "Expectant management and antenatal corticosteroids should be considered in late preterm infants with PPROM." 07/01/2017 - "A larger prospective study is needed to determine if the benefit of corticosteroids outweighs the potential risks in PPROM."
3.	Ampicillin (Omnipen)FDA LinkGeneric 01/01/2022 - "The aim of our study is to examine the efficacy of ampicillin and Lactobacillus casei rhamnosus treatment in cases of PPROM remote from term. " 09/01/1988 - "Ampicillin prophylaxis in preterm premature rupture of the membranes: a prospective randomized study." 11/01/2015 - "Consideration should be made for changing ampicillin in women with PPROM to a regimen with better coverage of gram-negative Enterobacteriaceae." 01/01/2014 - "casei rhamnosus to ampicillin prolongs the latency period in patients with PPROM remote from term." 06/01/2009 - "Seven pregnant women hospitalized with preterm premature rupture of the membranes and colonized with ampicillin-resistant isolates of the family Enterobacteriaceae were included. "
4.	ProgesteroneFDA LinkGeneric 12/01/2022 - "According to the results of the present study; Rectal progesterone suppository in pregnant women with PPROM is associated with improved delivery outcomes such as neonatal APGAR score, increased latent delivery stage without complications or severe and dangerous complications, without increased risk of mortality and NICU hospitalization in infants, so prescribing suppository rectal progesterone in pregnant women with PPROM with a gestational age of 26 to 34 weeks is associated with positive outcomes and is recommended based on the findings and opinions of the researchers." 12/01/2022 - "According to the results of the present study; Rectal progesterone suppository in pregnant women with PPROM is associated with improved delivery outcomes such as neonatal APGAR score, increased latent delivery stage without complications or severe and dangerous complications, without increased risk of mortality and NICU hospitalization in infants, so prescribing suppository rectal progesterone in pregnant women with PPROM with a gestational age of 26 to 34 weeks is associated with positive outcomes and is recommended based on the findings and opinions of the researchers. " 04/01/2019 - "So far, no trials have been published evaluating natural vaginal progesterone in women with PPROM." 12/01/2017 - "This study was performed to determine the effect of rectal progesterone on the latent phase and maternal and neonatal outcome variables in females with PPROM. " 11/01/2021 - "These data suggest progesterone plays protective roles against PPROM through anti-microbial, anti-inflammatory, and anti-thrombogenic actions on human-term fetal amniotic membrane cells. "
5.	Ascorbic Acid (Vitamin C)FDA LinkGeneric 09/01/2013 - "The findings of this study also indicated that administration of ascorbic acid was a safe and effective method to reduce the incidence of PPROM. " 12/01/2014 - "This study was conducted to establish the association between maternal plasma vitamin C concentration in women with PPROM and women without PPROM and to study the difference in maternal morbidity, neonatal morbidity, and mortality. " 02/01/2013 - "The aim of this study is to evaluate the role of vitamin C supplementation in prevention of PPROM in women with a positive history of PPROM. " 09/01/2011 - "In the main study plasma vitamin C concentration was significantly lower in women with PPROM than controls without PPROM, 0.53 ± 0.05 vs. 0.58 ± 0.05 mg/dl; P = 0.0001. " 09/01/2011 - "This study examined the association between plasma vitamin C concentration and the risk of (PPROM) amongst pregnant women in a tertiary hospital setting. "
6.	ProcalcitoninIBA 01/01/2022 - "The blood sample of women with PPROM were collected to measure procalcitonin level. " 01/01/2010 - "Procalcitonin levels in the PPROM group were significantly higher than in cases of healthy pregnant women (1.17 vs 0.05 ng/ml; p < 0.001). " 01/01/2007 - "Procalcitonin concentrations in pPROM and PROM at term cases were comparable. " 10/01/2005 - "Procalcitonin levels in the pPROM group were significantly higher than in cases of amniorrhexis at term (1.50 vs 0.83 ng/mL; P < 0.001). " 01/01/2021 - "The objective of the study was to determine the efficacy of maternal serum procalcitonin levels in the early prediction of chorioamnionitis in women with PPROM. "
7.	Nitric Oxide (Nitrogen Monoxide)FDA Link 01/01/2011 - "CPAP combined with inhaled nitric oxide for treatment of lung hypoplasia and persistent foetal circulation due to prolonged PPROM." 06/01/2011 - "Early functional echocardiogram and inhaled nitric oxide: usefulness in managing neonates born following extreme preterm premature rupture of membranes (PPROM)." 01/01/2011 - "To demonstrate the efficacy of early continuous positive airway pressure (CPAP) combined with inhaled nitric oxide (iNO) for treatment of preterm infants with lung hypoplasia and persistent foetal circulation (PFC) due to very early PPROM and prolonged severe oligohydramnios. " 04/01/2009 - "We sought to determine if inhaled nitric oxide (iNO) administered to preterm infants with premature rupture of membranes (PPROM), oligohydramnios, and pulmonary hypoplasia improved oxygenation, survival, or other clinical outcomes. " 01/01/2023 - "To perform a systematic literature review to determine the effect of inhaled nitric oxide (iNO) on oxygenation, mortality and morbidity in preterm neonates with preterm prelabour rupture of membranes (PPROM) and early hypoxaemic respiratory failure (HRF). "
8.	Biomarkers (Surrogate Marker)IBA 01/01/2022 - "These results may be beneficial for developing biomarkers for screening and early diagnosis of PPROM and may provide effective preventative treatments." 04/28/2023 - "Only a few studies assessed biomarkers predicting pregnancy duration after PPROM. " 01/01/2022 - "This study has determined genomic and transcriptomic candidate biomarkers of SPTB and PPROM that require validation in diverse populations." 01/01/2022 - "This study aimed to identify early pregnancy biomarkers of SPTB and PPROM from the maternal genome and transcriptome. " 09/17/2021 - "Further studies are needed to examine if fibulin-1 could serve as biomarker for the risk of PPROM. "
9.	Interleukin-6 (Interleukin 6)IBA 11/01/2016 - "The mean serum IL-6 level for the women with PPROM was (20.2 ± 11.0 pg/ml), which was significantly greater than for the control subjects (13.9 ± 5.8 pg/ml, p < 0.001). " 09/01/2021 - "The aim of this study was to evaluate the role of IL-6 point-of-care test in amniotic fluid obtained from serial amniocentesis in expectantly managed women with PPROM between 24 and 34 weeks of gestation. " 11/01/2016 - "This study was done to assess the relationship between maternal serum IL-6 levels and fetomaternal outcome following PPROM. " 03/01/2012 - "Maternal serum IL-6 levels were significantly elevated in subjects with PPROM with infectious morbidity as compared to those without infectious morbidity in the present study. " 12/01/2021 - "The plasma IL-6 mean values were higher in the PPROM group versus healthy controls (18.88±0.31pg/ml vs 5.99±0.12 pg/ml ), P <0.0001. "
10.	CollagenIBA 05/01/2017 - "Insertion of a collagen plug was the only significant factor found on both univariate and multivariate analysis to be associated with an increased rate of PPROM (odds ratio, 3.1 (95% CI, 1.2-8.0); P = 0.006). " 01/01/2017 - "Furthermore, the findings suggested that the loss of collagen content in PPROM could result from degradation and/or suppressed expression of collagens." 01/01/2014 - "No evidence was found that collagen plugs reduce the risk of PPROM after FETO for CDH." 01/01/2014 - "The hazard ratio of plug use was 1.29 (95% CI, 0.76-2.19), which does not exclude a potentially increased risk for PPROM when a collagen plug is used. " 01/01/2014 - "A multivariable Cox regression model was used to investigate the association between collagen plug and latency while adjusting for risk factors for PPROM. "

Therapies and Procedures

1.	Antibiotic Prophylaxis 11/15/2022 - "Although universal screening and implementation of intrapartum antibiotic prophylaxis (IAP) has improved EOD outcomes, these interventions have not reduced the incidences of LOD or complications occurring early on during pregnancy such as PPROM and PTB. " 01/01/2017 - "Vaginal probiotics as an adjunct to antibiotic prophylaxis in women with PPROM prolonged the latency period and improved the perinatal outcome." 12/01/2023 - "The combination of vaginal probiotics and antibiotic prophylaxis has been shown to effectively improve perinatal outcomes in women with PPROM. " 07/01/2022 - "Vaginal probiotics as an adjunct to antibiotic prophylaxis in the management of preterm premature rupture of the membranes." 12/01/2018 - "Antibiotic prophylaxis at admission in women with preterm premature rupture of the membranes is recommended (Grade A). "
2.	Tocolysis 12/01/2020 - "We investigated whether a unit policy of tocolysis use after PPROM is associated with prolonged gestation and improved outcomes for very preterm infants in units that systematically use these other evidence-based treatments. " 01/01/1999 - "The results show that for the period of tocolysis and/or PPROM there is significant improvement of the Ps (from 0.90 +/- 0.9 to 2.35 +/- 1.5). " 12/01/2020 - "Compared to a unit policy of no-use of tocolysis after PPROM, a liberal or restricted policy is not associated with improved obstetric, neonatal or two-year outcomes." 09/08/2021 - "The primary objective of this study is to assess whether short-term (48 h) tocolysis reduces perinatal mortality/morbidity in PPROM at 22 to 33 completed weeks of gestation. " 10/01/2016 - "This randomized trial did not show a beneficial effect of prolonged tocolysis on neonatal outcomes or prolongation of pregnancy in women with PPROM without contractions. "
3.	Therapeutics 01/01/2022 - "The selection criteria included randomized control studies that compared a therapy to standard care (no therapy or placebo) in pregnancy and included PPRoM as an outcome. " 11/11/1995 - "The selected studies were randomised controlled trials of systemic antimicrobial therapy for prolongation of gestation in non-labouring women after preterm premature rupture of the membranes. " 01/01/2021 - "The primary aim is to evaluate whether oral probiotic therapy (Lactobacillus fermentum CECT5716) administered during PPROM between 24 and 34 weeks gestation prolongs pregnancy duration. " 01/01/2019 - "A re-evaluation of antimicrobial therapy in neonates with a maternal pPROM >5 days is advised." 12/01/2018 - "These findings define the mechanisms for matrix-directed therapeutics for pPROM."
4.	Induced Labor 10/01/2015 - "In this review of the existing literature on induction of labor in PPROM, we examine the differences in appropriate management of patients with early (32 weeks 0 days to 33 weeks 6 days) and near term (34 weeks 0 days to 36 weeks 6 days) PPROM, and compare the safety and efficacy of available treatment options. " 10/01/2020 - "The purpose of this study was therefore to evaluate the success rate of induction of labor for PPROM at 34 and 35 weeks of gestation in comparison with a higher gestational age. " 10/01/2015 - "A large randomized trial comparing expectant and labor induction in cases of PPROM between 33 and 37 weeks showed no benefit of labor induction but did not have the power to explore rare and severe complications. " 10/01/2012 - "From January 2007 until September 2009, we performed the PPROM Expectant Management versus Induction of Labor (PPROMEXIL) trial. " 01/01/2021 - "We consider expectant management to be an acceptable alternative to early labor induction in PPROM."
5.	Cesarean Section (Caesarean Section) 01/27/2022 - "In moderately to late PPROM, increased latency is associated with higher risk of EONI and cesarean section with no reduction in RDS." 04/01/2021 - "In all 3 years, patients with PPROM tended to choose vaginal delivery rather than cesarean section (CS) delivery (68.9% in 2012, P<0.001; 76.5% in 2014, P<0.001; 69.3% in 2017, P<0.001), and the rate of vaginal deliveries in 2014 was higher than that in 2012 and 2017 (P=0.027). " 01/05/2020 - "However, the influences of cesarean section (CS) on neonatal outcomes in preterm pregnancies complicated with PPROM are not well elucidated. " 01/01/2020 - "Patients without pPROM underwent Caesarean sections more often than women from the pPROM group (65.3% vs 45.2%; p < 0.001). " 09/01/2018 - "There were no differences in maternal age, gravidity, parity, race, history of caesarean sections or fetal gender between women with or without PPROM. "