PPROM guidelines: how care is decided

Assessment usually starts with your history and a careful examination of the fluid, while avoiding unnecessary vaginal examinations. The team may record temperature, pulse and blood pressure, check for tenderness or contractions, take blood or urine tests, and monitor the baby’s heartbeat. Ultrasound can add information about fluid and growth.

Guideline-based care is adjusted for gestational age, confirmed or suspected infection, labour, bleeding, fetal presentation, fetal wellbeing and the resources available for premature newborn care. There is no single plan that fits every pregnancy. Your clinicians should explain the reason for each recommendation and what findings would change it.

If PPROM is confirmed, the team may discuss antibiotics, corticosteroids for fetal lung development and other medicines according to gestation and local practice. Monitoring can be inpatient or arranged through specialist follow-up when appropriate. Ask about the purpose, timing and possible effects of an [Antenatal Steroid Injection](/treatments/pregnancy-and-birth-care/antenatal-corticosteroid-injection/). Keep a record of symptoms and follow the unit’s instructions about returning for review.

Seek maternity advice immediately for fever, chills, feeling unwell, abdominal pain or tenderness, regular contractions, vaginal bleeding, foul-smelling or green fluid, or reduced fetal movement. These findings can point to infection, labour, bleeding or fetal compromise. Do not wait for the next planned check if symptoms change.

Ask how rupture was confirmed, which observations and tests are planned, what treatment is recommended at your gestation, and what would prompt delivery. Discuss the likely birth setting and whether [Induction of Labour](/treatments/pregnancy-and-birth-care/induction-of-labour/) could be used if birth is advised. Request clear out-of-hours contact instructions before leaving hospital.