Abstract
Prelabour rupture of membranes (PROM) refers to the disruption of foetal membranes before the onset of labour, resulting in the leakage of amniotic fluid. PROM complicates 3% and 8% of preterm and term pregnancies, respectively. Accurate and timely diagnosis is crucial for effective management to prevent adverse maternal- and foetal-outcomes. The diagnosis of equivocal PROM cases with traditional methods often becomes challenging in current obstetrics practice; therefore, various novel biochemical markers have emerged as promising diagnostic tools. This narrative review is sought to review the published data to understand the current and emerging trends in diagnostic modalities in term and preterm pregnancies complicated with PROM and the potential role of various markers for predicting preterm PROM (pPROM) and chorioamnionitis in women with pPROM.
Highlights
Prelabour rupture of the membranes (PROM) refers to the leaking of amniotic fluid before labour onset, caused by the breakage of foetal membranes
Following keywords were used for this narrative review: prelabour rupture of membranes (PROM), preterm prelabour rupture of membranes, Fern test, chorioamnionitis, biochemical markers, biomarkers, foetal fibronectin, alpha-fetoprotein (AFP), placental alpha microglobulin-1 (PAMG-1), insulin-like growth factor binding protein-1 (IGFBP-1), monoclonal/ polyclonal antibody immunoassay tests, amniotic fluid interleukin-8 (IL-8) and placental protein 14 (PP14)
This study suggested considering PP14 as a novel potential biomarker for Preterm PROM (pPROM) as it is unaffected by blood in the cervical-vaginal fluid
Summary
Prelabour rupture of the membranes (PROM) refers to the leaking of amniotic fluid before labour onset, caused by the breakage of foetal membranes. PROM may occur at term or earlier [1, 2]. It affects 5% to 10% of all pregnancies, 8% of term pregnancies and 3% of preterm pregnancies [3, 4]. PROM at term is associated with adverse maternal and perinatal sequelae such as placental abruption, cord compression, cord prolapse, risk of cesarean birth, and maternal and neonatal infection [3, 5–9]. Preterm PROM (pPROM) is associated with foetal- and maternal-morbidity and mortality including umbilical cord compression and prolapse [10], oligohydramnios, placental abruption [11–13], necrotising enterocolitis, respiratory distress syndrome, foetal death [1, 14], maternal intra-amniotic and postpartum infection risks [2, 4, 15–17]. Chorioamnionitis is associated with neurodevelopment handicap in preterm infants, early-onset sepsis and severe intraventricular haemorrhage [18–20]
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