The 34-36 WK PPROM Dilemma

In 2018, the ACOG recommended immediate induction of labor/delivery for patients with PPROM, who had sure gestational dating, and were at 34 weeks and 0 days or more. This was in order to reduce the risk of neonatal sepsis. This changed, however, in 2020 with ACOG Practice Bulletin 217 which discussed expected management for PPROM in the late preterm interval. Nonetheless, as is our tagline for this podcast, “medicine moves fast”. In February 2023, a current commentary was published in BJOG adding a cautionary note to the option of expected management in the late preterm interval. In this episode, we will review the acog guidelines, review GBS culture versus NAAT, and summarize this current commentary from BJOG. What is the one clinical factor that should be considered in planning for expected management with PPROM in the late preterm interval? We will explain it in this episode.