Premature rupture of membranes (PROM) is defined as spontaneous fetal membrane rupture before labor. Membrane rupture is called preterm when it occurs before 37 weeks of pregnancy. About 10% of all pregnancies are complicated by PROM, and in 80% of cases, pregnancy occurs, while in 30-35% of cases it is the cause of premature parts.
The mechanisms that induce early labor are related to the activation of the immune system: the production of prostaglandins, downstream of the activation cascade, has a stimulating effect on uterine contractility. Furthermore, degradation of the extracellular matrix of fetal membranes occurs, leading to their premature rupture, thanks to the production of specific enzymes.
It turns out to be beneficial factors: cervical and vaginal infections, even asymptomatic; weakening of the structures constituting the amniotic bag; uterine abnormalities (initial dilation and / or shortening); multiple pregnancy; polyhydramnios; traumas, premature preterm delivery, late abortion and / or premature membrane rupture before the 37th week.
Fewer risk factors are also: cigarette smoking and drug use; bleeding in pregnancy; lack of vitamins and / or mineral salts; previous surgeries on the uterus (conjunctivitis, cervical spine, 2 or more scarring); maternal diseases (hypertension, diabetes, anemia). Even psychological and social stress, economic instability and material difficulties increase chances. Depression has similar effects both for its behaviors, such as the use of alcohol drugs and cigarettes, both for peculiar aspects of mental illness. The complications of premature membrane rupture are all the more frequent and serious as early as the gestational age to which the PROM occurs.
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