RN Nursing · High-Risk Pregnancy — Preterm Labor · Practice question
A woman who is 33 weeks pregnant is admitted to the obstetric unit because her membranes ruptured spontaneously. What complication should the nurse closely assess for this patient?
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Hypotension
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Amniotic fluid embolism
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Hemorrhage
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✓
Chorioamnionitis
Answer & explanation
Correct: Chorioamnionitis
Premature rupture of membranes (PROM) at 33 weeks creates a direct pathway between the vaginal environment and the amniotic cavity. Once the protective barrier is broken, ascending bacteria can colonize the amniotic fluid, fetal membranes, and placenta, leading to chorioamnionitis — an infection of the chorion and amnion. This is the most common and serious complication directly associated with prolonged membrane rupture, particularly in a preterm patient who may require expectant management for days. Signs include maternal fever, uterine tenderness, foul-smelling amniotic fluid, maternal and fetal tachycardia, and elevated white blood cell count. Hypotension is not a primary complication of PROM and would suggest a different etiology such as hemorrhage or septic shock if severe infection develops. Amniotic fluid embolism is an extremely rare, unpredictable event that occurs at or around delivery and is not specifically linked to preterm PROM. Hemorrhage is associated with conditions such as placenta previa or placental abruption, not directly with membrane rupture in isolation. Because chorioamnionitis poses risks of neonatal sepsis, maternal sepsis, and preterm birth complications, nurses must vigilantly monitor temperature, fetal heart rate patterns, and uterine tenderness in clients experiencing PROM.
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