WordNet

state of being torn or burst open
the act of making a sudden noisy break
a personal or social separation (as between opposing factions); "they hoped to avoid a break in relations" (同)breach, break, severance, rift, falling out
born after a gestation period of less than the normal time; "a premature infant"
uncommonly early or before the expected time; "illness led to his premature death"; "alcohol brought him to an untimely end" (同)untimely
a thin pliable sheet of material
a pliable sheet of tissue that covers or lines or connects the organs or cells of animals or plants (同)tissue layer

PrepTutorEJDIC

〈U〉〈C〉(…の)破裂《+『of』+『名』》 / 〈U〉〈C〉(友好的関係などの)決裂,仲たがい / 〈C〉裂け目 / 〈C〉脱腸,ヘルニア / …‘を'破裂させる / 〈友好関係など〉‘を'断ち切る / 破裂する
《所有・所属》…『の』,…のものである,…に属する・《材料・要素》…『でできた』,から成る・《部分》…『の』[『中の』] ・《数量・単位・種類を表す名詞に付いて》…の・《原因・動機》…『で』,のために(because of) ・《主格関係》…『の』,による,によって・《目的格関係》…『を』,の・《同格関係》…『という』・《関係・関連》…『についての』[『の』],の点で・《抽象名詞などと共に》…の[性質をもつ] ・《『It is』+『形』+『of』+『名』+『to』 doの形で,ofの後の名詞を意味上の主語として》・《分離》…『から』・《起原・出所》…『から』[『の』](out of) ・《『名』+『of』+『a』(『an』)+『名』の形で》…のような・《『名』+『of』+『mine』(『yours, his』など独立所有格)の形で》…の…・《時》(1)《副詞句を作って》…に《形容詞句を作って》…の・《時刻》《米》…前(to,《米》before)
時期尚早の,早すぎた / 早計の,早まった / 早産の
(生物の)膜,皮膜
OLD French古[代]フランス語

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2012/10/18 11:32:15」(JST)

wiki en

Premature rupture of membranes (PROM) is a condition that occurs in pregnancy when there is rupture of the membranes (rupture of the amniotic sac and chorion) more than an hour before the onset of labor. PROM is prolonged when it occurs more than 18 hours before labor. PROM is preterm (PPROM) when it occurs before 37 weeks gestation.^[1] Risk factors for PROM can be a bacterial infection, smoking, or anatomic defect in the structure of the amniotic sac, uterus, or cervix. In some cases, the rupture can spontaneously heal, but in most cases of PROM, labor begins within 48 hours. When this occurs, it is necessary that the mother receives treatment to avoid possible infection in the newborn.^[2]

Risk factors

Maternal risk factors for a premature rupture of membranes include chorioamnionitis or sepsis. Association has been found between emotional states of fear in a population and prelabor rupture of membranes at term.^[3] Fetal factors include prematurity, infection, cord prolapse, malpresentation or genetic mutations

Note

This entry mistakenly includes both PROM and PPROM; PROM refers to term ROM and is incorrectly applied to preterm (under 37 weeks gestation) ROM. These are 2 very distinct entities with different causes, different management, and very different outcomes—PROM is a variation of normal, PPROM is often caused by subclinical infection and is quite dangerous.

Assessment

Assessment of a rupture of membranes involves taking a proper medical history, a gynecological exam using a speculum, nitrazine, cytologic (ferning) tests, and ultrasound. Amniotic fluid, when dried for 10 minutes on a slide and then viewed under a microscope, shows a characteristic fernlike pattern. Cervical mucus can also show ferning, but the fern-like shapes are usually smaller. Assessment for rupture of membranes can also involve dipstick tests on fluid or discharge, such as Actim Prom^[4] or Amnisure.^[5]

Management

In a term pregnancy where premature rupture of membranes has occurred, spontaneous labor can be permitted. Current obstetrical management includes an induction of labor at approximately 12 hours if it has not already begun though many physicians believe it to be safe to induce labor immediately, and consideration of Group B Streptococcal prophylaxis at 18 hours.

Preterm birth:
- Tocolysis is also sometimes used, though its use in this context is controversial. The mother should be admitted to hospital and put under careful surveillance for preterm labor and chorioamnionitis. Induction of labor should happen at around 34 weeks.
- Antenatal steroids if the gestational age is less than 32 weeks.

Infection
- Maternal: If chorioamnionitis is present at the time of PPROM, antibiotic therapy is usually given to avoid sepsis, and delivery is indicated. If chorioamnionitis is not present, prompt antibiotic therapy can significantly delay delivery, giving the fetus crucial additional time to mature.^[6] In preterm premature rupture of membranes (PPROM), antibiotic therapy should be given to decrease the risk of sepsis. Ampicillin or erythromycin should be administered for 7 days
- Fetal: If the GBS status of the mother is not known, Penicillin or other antibiotics may be administered for prophylaxis against vertical transmission of Group B streptococcal infection.

References

^ Deering SH, Patel N, Spong CY, Pezzullo JC, Ghidini A (2007). "Fetal growth after preterm premature rupture of membranes: is it related to amniotic fluid volume?". J. Matern. Fetal. Neonatal. Med. 20 (5): 397–400. doi:10.1080/14767050701280249. PMID 17674244.
^ Simhan H, Canavan T (March 2005). "Preterm premature rupture of membranes: diagnosis, evaluation and management strategies". BJOG 112 (Supplement 1): 32–37. doi:10.1111/j.1471-0528.2005.00582.x. PMID 15715592. http://www.blackwellpublishing.com/bjog.
^ Santos Leal, Emilio; Odent, Michel R; Vidart Aragon JA, Coronado Martin P, Herraiz Martinez MA (December 2006). "Premature Rupture of Membranes and Madrid Terrorist Attack". Birth 33 (4): 341. doi:10.1111/j.1523-536X.2006.00136 1.x.
^ "Actim Prom" at medixbiochemica.com
^ "Amnisure" at amnisure.com
^ Melis GB, Orrù M, Uras R, et al. (October 2007). "Chorioamnionitis". J Chemother 19 Suppl 2: 17–9. PMID 18073173. http://www.jchemother.it/cgi-bin/digisuite.exe/searchresult?range=pubmed&volume=19%20Suppl%202&year=2007&firstpage=17.

UpToDate Contents

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1. 前期破水による早産 preterm premature rupture of membranes
2. 妊娠満期に生じる前期破水による早産のマネージメント management of premature rupture of the fetal membranes at term
3. 妊娠中期の前期破水による早産 midtrimester preterm premature rupture of membranes
4. 妊産婦の施設間搬送 inter facility maternal transport
5. B型肝炎と妊娠 hepatitis b and pregnancy

English Journal

Extracellular matrix dynamics and fetal membrane rupture.

Strauss JF 3rd.Source1Department of Obstetrics & Gynecology, Virginia Commonwealth University, Richmond, VA, USA.
Reproductive sciences (Thousand Oaks, Calif.).Reprod Sci.2013 Feb;20(2):140-53. doi: 10.1177/1933719111424454. Epub 2012 Jan 19.
The extracellular matrix (ECM) plays an important role in determining cell and organ function: (1) it is an organizing substrate that provides tissue tensile strength; (2) it anchors cells and influences cell morphology and function via interaction with cell surface receptors; and (3) it is a reserv
PMID 22267536

Pregnancy Disorders Appear to Modify the Risk for Retinopathy of Prematurity Associated With Neonatal Hyperoxemia and Bacteremia.

Lee JW, McElrath T, Chen M, Wallace DK, Allred EN, Leviton A, Dammann O.Source1 Newborn Medicine, Floating Hospital for Children at Tufts Medical Center, Boston, MA.
The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians.J Matern Fetal Neonatal Med.2013 Jan 9. [Epub ahead of print]
Abstract Objective: To explore (1) whether extremely low gestational age newborns exposed to inflammation-associated pregnancy disorders differ in retinopathy of prematurity (ROP) risk from infants exposed to placenta dysfunction-associated disorders, and (2) whether ROP risk associated with postn
PMID 23297684

Cervical Insufficiency: A New Issue for Guidelines on Prevention of Perinatal Group B Streptococcal Disease?

Natale F, Brunelli R, Bizzarri B, Castronovo A, De Curtis M.SourceDipartimento di Pediatria e Neuropsichiatria Infantile, and.
Pediatrics.Pediatrics.2013 Jan 6. [Epub ahead of print]
The updated Guidelines on Prevention of Perinatal Group B Streptococcal Disease, issued by the Centers for Disease Control and Prevention, actually represent the mainstay in the prevention of neonatal early-onset group B streptococcal (GBS) sepsis. According to these guidelines, patients with possib
PMID 23296432

Japanese Journal

潮の満ち引きと分娩開始の関連性

母性衛生 56(4), 652-657, 2016-01
NAID 40020711690

症例報告早期の前期破水による長期羊水過少にかかわらず,良好な新生児予後を呈した1例

東京産科婦人科学会会誌 64(3), 437-441, 2015-07
NAID 40020576994

症例報告羊水穿刺後に完全破水となった胎児染色体48,XXYYの1例

東京産科婦人科学会会誌 64(3), 376-379, 2015-07
NAID 40020576668

Related Pictures

★リンクテーブル★

リンク元	「前期破水」「preterm PROM」
関連記事	「rupture」「premature」「membrane」

「前期破水」

Premature rupture of membranes
	Classification and external resources
ICD-10	O42
ICD-9	658.1
DiseasesDB	10600
eMedicine	med/3246
MeSH	D005322

　　[★]

英: premature rupture of the membranes, premature rupture of membranes, PROM
同: premature rupture fetal membrane
関: 破水。プレタームPROM preterm PROM

定義

陣痛開始以前に卵膜の破綻を起こしたもの　←　陣痛発生以降は分娩第一期。第一期より前なので「前期破水」と覚える

特に、妊娠37週未満の前期破水をpreterm PROM　←　ちなみに、妊娠37週未満での出産は早産と定義される

定義のまとめ

前期破水の妊娠期間による別

preterm PROM	妊娠37週未満の前期破水
term PROM = PROM	妊娠37週以降の前期破水

破水の分娩のステージによる分類

前期破水	陣痛前の破水	分娩第一期未満
早期破水	陣痛開始後、子宮口が全開大に至る以前の破水	分娩第一期以降～分娩第二期未満