Management of Preterm Premature Rupture of Membranes (PPROM) at 22 Weeks: Conservative or Termination? A Case Report

Introduction: Preterm premature rupture of membranes (PPROM) is an obstetrics condition that outcomes can vary significantly depending on gestational age. Significant maternal and fetal complications may arise, including premature birth, infection, placental abruption, cord prolapse, pulmonary hypoplasia, and even death. PPROM at 22 weeks of gestation is a rare condition that carries a high risk of morbidity and mortality.Case Presentation: Mrs. YS, 29 years old, G2P0A1, with a gestational age of 22-23 weeks, singleton live intrauterine, has experienced PPROM. At the beginning of her admission, termination was recommended; however, the patient declined and desired to continue the pregnancy. Consequently, a conservative management approach was implemented. The patient was prescribed antibiotic therapy, lung maturation, and monitored for signs of chorioamnionitis. A male baby was born via cesarean section at 28-29 weeks of gestational age due to suspected chorioamnionitis, weighing 850 grams. The baby received treatment with CPAP and antibiotics but passed away after two weeks.Discussion: Conservative management can prolong pregnancy and improve neonatal survival chances, but it carries a high risk of maternal infection, sepsis, and complications related to prematurity. Meanwhile, termination of pregnancy is more commonly performed in cases with poor neonatal prognosis or when there are medical indications that threaten the mother's safety.Conclusion: The decision between conservative management and termination in cases of PPROM at 22 weeks of gestation must consider fetal prognosis, maternal risks, and the readiness of medical facilities. Comprehensive counseling for the patient and family is crucial in the decision-making process.