Premature rupture of membranes: The Daily PANCE Blueprint

Home Premature rupture of membranes: The Daily PANCE Blueprint

Premature rupture of membranes: The Daily PANCE Blueprint

A 30-year-old woman at 36 weeks gestation presents with clear vaginal fluid leakage for 5 hours. She has no contractions or fever. Sterile speculum exam shows minimal pooling. Nitrazine test is negative, but ferning is present. What is the next best step?

A. Administer corticosteroids
B. Begin tocolysis
C. Perform digital cervical exam
D. Induce labor
E. Observe and reassess

Answer and topic summary

The answer is D. Induce labor

Premature rupture of membranes is defined as the rupture of membranes occurring before the onset of labor. Risk factors include previous PROM, smoking, infection, and multiple pregnancies. A classic clinical feature is a gush of fluid from the vagina and increased discharge. Diagnostic work-up includes a sterile speculum exam (will see pooling), positive nitrazine and fern test. Treatment is delivery by the induction of labor in stable patients.

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Smarty PANCE Content Blueprint Review:

Covered under ⇒ PANCE Blueprint Reproductive System ⇒ Complicated Pregnancy (PEARLS) ⇒ Prelabor rupture of membranes

Also covered as part of the Emergency Medicine EOR and Women's Health EOR topic lists

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