Antibiotic prophylaxis in preterm rupture of membranes

Preterm premature rupture of membranes (PPROM) occurs before 37 weeks of gestation, accounting for approximately one-third of cases of preterm birth and increased maternal and neonatal morbidity and mortality. Several protocols recommend expectant management between 24 and 36 weeks of gestation, in order to allow acomplishment of fetal maturation and to avoid the dramatic consequences of prematurity. Despite benefits related to gestational prolongation, the most feared risk from this protocol is the increase of maternal-fetal infection. For this reason, the use of prophylactic antibiotics is recommended, although there is no consensus regarding the best choice. The objective of the present review was to analyze the impact of antibiotic prophylaxis on maternal and neonatal outcomes in cases of PPROM. It was observed that further studies are needed with the aim of standardizing the best antibiotic regimen in PPROM, as well as defining the actual maternal and neonatal outcomes, at long term, from its use.