PRETERM PRE-LABOR AMNIORRHEXIS

In pregnancies complicated by pre-term pre-labour amniorrhexis, there is a risk of intra-uterine infection, which is associated with materna l and perinatal mortality and morbidity. The causes of neonatal death in pregnancies with amniorrhexis are prematurity, pulmonary hypoplasia and sepsis. In the management of pregnancies with preterm pre-labour amniorrhexis, it is essential to distinguish between those with and wi thout intra-uterine infection, If there is no infection at presentatio n, it is unlikely that this will develop, and in such cases there is n o benefit from hospitalization, bed rest, prophylactic tocolytics or a ntibiotics. The group with evidence of intra-uterine infection go into spontaneous labour within a few days of amniorrhexis; in this group, the main determinant for the appropriate management is the gestational age at amniorrhexis.