The PPROM Foundation

Research Library

Clinical Overviews & Professional Guidance

Previable & Perivable PPROM

Latency & Expectant Management

Diagnosis & Biomarkers

Infection, Inflammation & the Microbiome

Antibiotics

Corticosteroids & Magnesium Sulfate

Pulmonary Hypoplasia & Respiratory Outcomes

Maternal Health & Safety

Neonatal Outcomes

Long-Term Childhood Outcomes

Placental Abruption & Chronic Abruption Oligohydramnios Sequence

Risk Factors, Recurrence & Future Pregnancy

Patient & Family Experience

Emerging Research: Fetal Membrane Healing & Repair

About This Research Library

Research Library

The PPROM Foundation is committed to sharing current research about preterm prelabor rupture of membranes (PPROM), including research on causes, diagnosis, treatment, maternal health, pregnancy outcomes, neonatal outcomes, and long-term health.

Research surrounding PPROM continues to evolve. Outcomes and treatment recommendations can vary significantly depending on gestational age at membrane rupture, gestational age at delivery, remaining amniotic fluid, infection, pregnancy complications, neonatal care available, and many other individual factors.

The publications below are provided for education and further reading. They are not intended to replace individualized medical advice or consultation with a maternal-fetal medicine specialist or other qualified healthcare professional.

Last Literature Review: August 2026

Clinical Overviews & Professional Guidance

2024 | Professional Guidance

Society for Maternal-Fetal Medicine Consult Series #71: Management of Previable and Periviable Preterm Prelabor Rupture of Membranes

Society for Maternal-Fetal Medicine (SMFM)

Current U.S. specialty guidance addressing counseling and management after PPROM during the previable and periviable period.

Open Access

2025 | Professional Guidance

Care of Women with Preterm Prelabour Rupture of the Membranes Prior to 24+0 Weeks of Gestation — Scientific Impact Paper No. 76

Royal College of Obstetricians and Gynaecologists (RCOG)

Comprehensive review of emerging evidence, outcomes, counseling and management of PPROM occurring before 24 weeks of pregnancy.

Open Access

Previable & Perivable PPROM

PPROM occurring very early in pregnancy presents unique maternal, fetal and neonatal considerations. Research in this area is changing rapidly, and outcomes reported by individual studies can differ significantly depending on which pregnancies and infants are included.

2024 | Maternal & Perinatal Outcomes

Preterm Prelabour Rupture of Membranes Before 23 Weeks' Gestation: Prospective Observational Study

Goodfellow L, et al. BMJ Medicine.

A national prospective UK study examining both maternal and infant outcomes following PPROM between 16+0 and 22+6 weeks of gestation.

Open Access

2025 | Extremely Preterm Outcomes

Outcomes of Extremely Preterm Infants Exposed to Prolonged Prelabor Rupture of Membranes Before 24 Weeks of Gestation

Younge NE, et al.

A contemporary U.S. multicenter study from the NICHD Neonatal Research Network examining survival and neurodevelopmental outcomes among extremely preterm infants exposed to prolonged PPROM before 24 weeks.

Open Access

2025 | Neonatal Outcomes

Neonatal Outcomes Following Previable Rupture of Membranes Below 23 Weeks' Gestation

Grill A, et al.

Examines neonatal survival and complications following PPROM occurring before 23 weeks.

Open Access

2026 | Pregnancy & Neonatal Outcomes

Previable Preterm Premature Rupture of Membranes Before 24 Weeks Gestation: Pregnancy and Neonatal Outcomes

Cossart A, et al.

A contemporary cohort examining neonatal outcomes and factors associated with mortality and severe neonatal morbidity following PPROM before 24 weeks.

Open Access

Latency & Expectant Management

Latency refers to the period of time between rupture of membranes and delivery. Latency varies greatly between pregnancies and cannot be predicted precisely for an individual patient.

2024 | Inpatient vs. Outpatient Care

Outpatient vs Inpatient Management of Preterm Prelabor Rupture of Membranes: A Systematic Review and Meta-analysis

Williamson M, et al.

Reviews available evidence comparing hospital management with outpatient management for carefully selected patients with PPROM. Evidence remains limited, and outpatient management is not appropriate for every pregnancy.

Open Access

2026 | Latency

Latency Following Preterm Prelabor Rupture of Membranes: Maternal and Perinatal Outcomes

López-Martínez P, et al.

Recent research examining latency and maternal and neonatal outcomes following PPROM.

Open Access

Diagnosis & Biomarkers

PPROM is generally diagnosed clinically. Research continues into additional biomarkers that may help identify membrane rupture, inflammation, infection, or pregnancies at increased risk.

2024 | Vaginal Microbiome & Diagnosis

The Microbiome Biomarkers of Pregnant Women's Vaginal Fluid for the Diagnosis of PPROM

Research examining whether patterns within the vaginal microbiome may contribute to future PPROM diagnostic tools.

Open Access

2025 | Maternal Inflammatory Biomarkers

Evaluation of Maternal Inflammatory Biomarkers in Preterm Premature Rupture of Membranes

Research evaluating maternal inflammatory markers in pregnancies complicated by PPROM.

Open Access

Infection, Inflammation & the Microbiome

Infection and inflammation are closely associated with PPROM, although the relationship is complex. Infection may contribute to membrane weakening in some pregnancies, while membrane rupture can also increase the risk of ascending infection.

2024 | Intraamniotic Infection Guidance

ACOG Clinical Practice Update: Update on Criteria for Suspected Diagnosis of Intraamniotic Infection

American College of Obstetricians and Gynecologists; endorsed by SMFM.

Updated professional guidance regarding the clinical diagnosis of suspected intraamniotic infection.

Open Access

2025 | Vaginal Microbiome

The Role of the Vaginal Microbiome in Preterm Premature Rupture of Membranes

Alikamali M, et al.

Review of current evidence exploring relationships between vaginal microbial communities, inflammation and PPROM.

Open Access

2025 | Microbiota & Biomarkers

Interaction of Vaginal Microbiota and Biomarkers in Premature Rupture of Membranes: From Bench to Bedside

Deng Y, et al.

Review of microbiome changes, inflammatory pathways, biomarkers and potential future approaches to prevention and management.

Open Access

2025 | Placental Inflammation

Placental Inflammation in Preterm Premature Rupture of Membranes

Examines inflammatory processes involving the placenta and fetal membranes in PPROM.

Open Access

Antibiotics

Antibiotics are commonly used during expectant management of PPROM at appropriate gestational ages to reduce infection-related complications and prolong pregnancy. Antibiotic selection and timing should follow current obstetric guidance.

Current Guidance

Society for Maternal-Fetal Medicine Consult Series #71: Management of Previable and Periviable PPROM

Includes current recommendations regarding antibiotic use following previable and periviable PPROM.

Open Access

Corticosteroids & Magnesium Sulfate

Antenatal corticosteroids may be used when preterm delivery is anticipated to support fetal maturation. Magnesium sulfate may be recommended at appropriate gestational ages for fetal neuroprotection.

The timing of these treatments depends on gestational age, anticipated delivery, neonatal resuscitation plans and individual clinical circumstances.

Current Guidance

Society for Maternal-Fetal Medicine Consult Series #71: Management of Previable and Periviable PPROM

Includes recommendations regarding when antenatal corticosteroids and magnesium sulfate should be considered following very early PPROM.

Open Access

Amniotic Fluid & Oligohydramnios

PPROM can result in low amniotic fluid, or oligohydramnios, and in some cases near-complete absence of measurable fluid, or anhydramnios.

Residual fluid, gestational age, duration of low fluid and fetal lung development are among the factors researchers continue to study in relation to PPROM outcomes.

2026 | Amniotic Fluid & Respiratory Outcome

PROMISE — Impact of Maternal and Neonatal Risk Factors on the Respiratory Outcome of Extremely Preterm Infants Following PPROM in the Second Trimester of Pregnancy

Brickmann C, et al.

Examines respiratory outcomes following second-trimester PPROM, including the effects associated with prolonged oligo-/anhydramnios and pulmonary hypoplasia.

Open Access

Pulmonary Hypoplasia & Respiratory Outcomes

When PPROM occurs very early in pregnancy, prolonged low amniotic fluid can interfere with normal lung development. The degree of pulmonary impairment varies substantially between infants.

2026 | Respiratory Outcomes

PROMISE — Impact of Maternal and Neonatal Risk Factors on the Respiratory Outcome of Extremely Preterm Infants Following PPROM in the Second Trimester of Pregnancy

Brickmann C, et al.

Contemporary research examining respiratory outcomes among extremely preterm infants following second-trimester PPROM.

Open Access

Maternal Health & Safety

PPROM can present significant maternal health risks, particularly from infection, hemorrhage and placental complications. Maternal health is an important part of counseling and decision-making at every gestational age.

2024 | Maternal Outcomes

Preterm Prelabour Rupture of Membranes Before 23 Weeks' Gestation: Prospective Observational Study

Goodfellow L, et al. BMJ Medicine.

This national prospective study reports maternal as well as perinatal outcomes following PPROM before 23 weeks and highlights the importance of maternal infection and sepsis risk.

Open Access

Neonatal Outcomes

PPROM studies report outcomes in different ways. Some begin with all pregnancies diagnosed with PPROM, while others include only pregnancies managed expectantly, live births, infants admitted to intensive care, or infants who received active treatment.

Because the denominator differs between studies, survival percentages from different publications should not be compared without understanding which population was studied.

2025 | Extremely Preterm Infants

Outcomes of Extremely Preterm Infants Exposed to Prolonged Prelabor Rupture of Membranes Before 24 Weeks of Gestation

Younge NE, et al.

Multicenter U.S. data examining mortality, neonatal morbidity and neurodevelopment among extremely preterm infants following prolonged PPROM.

Open Access

2025 | PPROM Below 23 Weeks

Neonatal Outcomes Following Previable Rupture of Membranes Below 23 Weeks' Gestation

Grill A, et al.

Recent cohort examining neonatal outcomes following very early PPROM.

Open Access

2026 | PPROM Before 24 Weeks

Previable Preterm Premature Rupture of Membranes Before 24 Weeks Gestation: Pregnancy and Neonatal Outcomes

Cossart A, et al.

Examines pregnancy and neonatal outcomes and factors associated with serious neonatal complications.

Open Access

Long-Term Childhood Outcomes

Survival to hospital discharge is only one important outcome. Increasingly, researchers are following children after PPROM into infancy and early childhood to better understand developmental and health outcomes.

2026 | Neurodevelopment at 2–3 Years

Long-Term Outcomes After Previable pPROM: Implications for Counselling at the Limit of Viability

Grill A, et al.

Examines neurodevelopmental outcomes at approximately 2–3 years among survivors following PPROM before 23 weeks.

Open Access

2025 | Extremely Preterm Neurodevelopment

Outcomes of Extremely Preterm Infants Exposed to Prolonged Prelabor Rupture of Membranes Before 24 Weeks of Gestation

Younge NE, et al.

Includes neurodevelopmental follow-up in addition to neonatal outcomes.

Open Access

Placental Abruption & Chronic Abruption Oligohydramnios Sequence

Placental abruption may occur with PPROM and can also be associated with chronic bleeding and oligohydramnios.

Chronic abruption-oligohydramnios sequence (CAOS) is a rare condition involving persistent or recurrent bleeding followed by development of oligohydramnios.

2025 | CAOS Outcomes

Perinatal Outcomes of Chronic Abruption Oligohydramnios Sequence

Kasuga Y, et al.

Recent research examining pregnancy and neonatal outcomes associated with CAOS.

Open Access

Risk Factors, Recurrence & Future Pregnancy

PPROM is not always preventable, and in many pregnancies a single identifiable cause is never found.

Research continues into maternal, pregnancy, genetic, environmental, inflammatory and microbial factors associated with membrane rupture.

2024 | Risk Factors

Risk Factors for Premature Rupture of Membranes in Pregnant Women: A Systematic Review and Meta-analysis

Lin D, et al. BMJ Open.

Systematic review and meta-analysis examining factors associated with premature rupture of membranes.

Open Access

2026 | Recurrence

Risk of Recurrent Preterm Premature Rupture of Membrane in Subsequent Pregnancy: A Systematic Review and Meta-analysis

Min Y, et al.

Systematic review examining the risk of PPROM and preterm birth in pregnancies following a previous PPROM pregnancy.

Open Access

Patient & Family Experience

PPROM affects far more than pregnancy management. Uncertainty, prolonged hospitalization, difficult decisions, separation from family, pregnancy loss, premature birth and neonatal intensive care can all contribute to significant emotional and practical burdens.

Patient-centered research can help improve counseling, communication and support.

2024/2025 | Patient Experience & Support

Preterm Premature Rupture of the Membranes (PPROM): A Study of Patient Experiences and Support Needs

Challacombe FL, Suchomelova Z, Avena-Zampieri C, et al. Journal of Reproductive and Infant Psychology.

Research specifically examining the experiences of patients affected by PPROM and identifying areas where information, psychological care and practical support can be improved.

Open Access

Emerging Research: Fetal Membrane Healing & Repair

Researchers are investigating whether ruptured fetal membranes might someday be physically sealed or encouraged to heal.

These approaches remain experimental. They should not be interpreted as established treatment options for spontaneous PPROM.

2025 | Tissue Engineering & Membrane Repair

Biomaterials for Fetal Membrane Repair in Preterm Premature Rupture of Membranes: Advances in Tissue Engineering Strategies

Fan L, et al.

Review of experimental approaches including bioadhesives, hydrogels, scaffolds, extracellular-matrix materials and other technologies being studied for fetal membrane repair.

Open Access

2026 | Fetal Membrane Research

Ex Vivo Model for Assessing Fetal Membrane Integrity and Repair

Moser L, et al.

Laboratory research developing models that may help scientists study fetal membrane integrity, injury and potential repair strategies.

Open Access

About This Research Library

The PPROM Foundation provides research links for educational purposes and does not endorse a specific treatment plan or use individual research studies to predict outcomes for individual pregnancies.

Whenever possible, we link directly to open-access full-text research, professional society guidance or publicly available clinical resources so that patients, families, clinicians and researchers can review the original source.

Research is periodically reviewed and updated as new evidence becomes available.

Last updated: August 2026

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