May be associated with trauma, although usually PROM is a spontaneous event.Patients will usually report if they see bleeding, but still important to ask and document.Darker or yellow color more suggestive of vaginal discharge especially if more viscous.Urine vs amniotic fluid is usually not easy to distinguish based on color.Urine or infection will have a smell | Amniotic fluid will not.Urine leakage usually associated with coughing or overextended bladder and usually not intermittent or continuous flow. Questions are Guided to Sort Out the Differential Diagnosis Other considerations include copious vaginal discharge.Main differential is usually that of urine leakage, associated with full bladder.Patient will report leaking of fluid from the vagina or wetness of the perineum.Below are key points to consider to evaluate and help make the diagnosis of PROM. False positive PROM diagnosis may lead to unnecessary interventions, whereas a negative PROM diagnosis may lead to less than expected maternal-fetal surveillance, both of which can lead to adverse perinatal outcomes. Preterm PROM (PPROM) prior to 37 week gestation is associated with over 1/3 of all preterm births, and poses a management dilemma when occurring prior to 22 to 23 weeks gestation. Prelabor rupture of membranes (PROM) refers to membrane rupture prior to onset of labor, and its management remains one of the most controversial issues in obstetrics.
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