Interventions / Treatment

In the United States, each state determined their Neonatal Intensive Care Unit (NICU) levels, criteria, and qualifications.

For the purposes of Expectant Management in PPROM, it is extremely important to find a high acuity NICU that can take care of your baby. Not every hospital will have the right equipment and staff to manage an extremely preterm delivery complicated by PPROM.

We advise that you research hospitals to determine the following:

  1. Does the hospital administer Nitric Oxide and Surfactant?
  2. Is there a neonatologist on staff at all times?
  3. Are there high-frequency ventilators (Jet & Oscillator) available on site?
  4. If your baby needs to be transferred for more care, which hospital would be recommended?

Progesterone is not recommended in pregnancies complicated by PPROM. However, it may be beneficial to discuss with your medical provider for future pregnancies.

Progesterone can be administered orally, via suppository (rectal or vaginal), or via intramuscular injections.

Progesterone inhibits in vitro fetal membrane weakening

The choice of progestogen for the prevention of preterm birth in women with singleton pregnancy and prior preterm birth

Effects of progestogens in women with preterm premature rupture of membranes

Use of progesterone supplement therapy for prevention of preterm birth: review of literatures