Antibiotics in the management of PROM and preterm labor.

Preterm labor or premature rupture of the membranes (PROM) continue to account for the majority of the nearly 500,000 preterm births that occur in the United States each year, and are of particular importance because of the resultant perinatal morbidity nd mortality, and the potential for long-term sequelae in these infants. In many ases, the inciting cause of preterm delivery remains unknown; however, intrauterine nfection and inflammation have long been specifically linked to preterm birth, specially that occurring remote from term. In both preterm labor and PROM, scending bacterial colonization of the decidua is believed to be a common inciting vent. Unfortunately, strategies to prevent preterm birth through administration of ntibiotics to asymptomatic women have met with limited success, and have in some ases led to an increased risk of prematurity. Because of this, attention has been given to antibiotic treatment of pregnancies complicated by acute preterm labor or after preterm PROM with the goal of prolonging pregnancy to allow further in utero development of the fetus. In this article, antibiotic therapy as an adjunct to the treatment of preterm labor and PROM for this indication is considered. Although there is considerable overlap between the clinical spectrum of preterm labor and preterm PROM, these entities are considered separately.