PPROM can result in birth injuries and fetal demise. In cases of birth injury following PPROM (preterm premature rupture of membranes), a detailed factual inquiry is necessary to determine whether the injuries were avoidable and preventable through timely detection and appropriate interventions. Under Ohio law, a parent may recover for injuries to a newborn that occur as a result of an obstetrician or midwife’s failure to recognize PPROM or delay in undertaking appropriate treatment.
PPROM generally refers to rupture of membranes that occurs before 27 weeks of gestation. It occurs in less than 1% of pregnancies and roughly 50% of those pregnancies result in a healthy baby. PPROM may occur due to infection, instrumentation (e.g., amniocentesis), mechanical breach of the amniotic sac, or spontaneously.
Rupture of membranes is detected based on leaking of fluid and confirmed by testing (e.g., nitrazine and fern tests). Failure to confirm the leak can lead to birth injuries from unnecessary early delivery — I have handled such a medical negligence case. Ultrasound is used to assess the extent of leakage.
The treatment of ruptured membranes depends on a number of factors, including gestational age, the presence of infection and the severity of the rupture. In some instances, the leak resolves on its own, particularly after amniocentesis. Other potential interventions include antibiotics to prevent or treat infection, steroids to minimize inflammation in the fetus, tocolytics to delay delivery, bed rest, and early delivery.
When mistakes are made in the management of ruptured membranes, a variety of complications can arise, including birth injuries (e.g., cerebral palsy) and death. PPROM requires prompt diagnosis and a thorough review of treatment options with the expecting parents.