MIDWIFERY CARE MANAGEMENT FOR 20-YEAR-OLD MRS. P, G1P0A0 GRAVIDA, 40 WEEKS IN PARTU, 1ST STAGE, ACTIVE PHASE WITH PREMATURE RUPTURE OF MEMBRANES AT THE TUTUN SEHATI PRATAMA CLINIC IN 2025
Keywords:
Premature Rupture of Membranes, Pregnant Women, Maternal Health, SDGs 2030Abstract
Premature rupture of membranes (PROM) in the Medan region varies between 6% and 19% of all pregnancies. Meanwhile, the national rate according to the Ministry of Health and Riskesdas ranges from 5.6% to 14.6%. The expected incidence of PROM in Indonesia is targeted to be significantly reduced to below 5% in order to prevent complications. This case report aims to describe the management of midwifery care for a pregnant woman with premature rupture of membranes and to support the achievement of the Sustainable Development Goals (SDGs) 2030, particularly Goal 3: Good Health and Well-being. The method used was a descriptive case report through a systematic midwifery care approach including assessment, diagnosis, planning, implementation, and evaluation. The case involved Mrs. P, a 20-year-old primigravida (G1P0A0) at 40 weeks of gestation with a single live intrauterine fetus in cephalic presentation and diagnosed with premature rupture of membranes during the active phase of the first stage of labor. The assessment results showed clear amniotic fluid discharge,cervical dilation of 1 cm, fetal heart rate of 156 beats/minute, and stable maternal vital signs. The management provided included monitoring maternal and fetal conditions, preventing infection,emotional support, collaborating with healthcare providers, and administering antibiotics. The mother delivered a baby girl spontaneously with a birth weight of 3100 grams and an Apgar score of 8. The implementation of comprehensive and continuous midwifery care successfully maintained maternal and newborn health and reduced the risk of complications. Early detection and appropriate management of PROM contribute to improving maternal and neonatal outcomes and support the achievement of SDGs 2030 targets in maternal and child health.
References
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Astuti, D. W., Kebidanan, A., & Husada, R. (2023). Karakteristik ibu bersalin dengan kejadian ketuban pecah dini. 8(1).
Che, A., Si, S., & Liu, J. (2025). Efficacy and safety of misoprostol versus oxytocin for labor induction in women with prelabor rupture of membranes : a meta- analysis.
Dayanan, R., Bayraktar, B., Karabay, G., Filiz, A. A., & Tonyali, N. V. (2025). Prognostic evaluation of albumin-associated inflammatory indices ( LAR , NAR , MAR , FAR , SII / Alb , SIRI / Alb , NPAR , and CAR ) in preterm premature rupture of membranes ( PPROM ) pregnancies. 6.
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Duangkum, C., Pattamathamakul, S., Chaiyarach, S., Sawanyawisuth, K., Chantanaviliai, S., & Pongsamakthai, M. (2025). European Journal of Obstetrics & Gynecology and Reproductive Biology : X Predictors of delivery at 48 hours or more in pregnant women with preterm prelabor rupture of membrane : A retrospective cohort study. European Journal of Obstetrics & Gynecology and Reproductive Biology: X, 26(January), 100393. https://doi.org/10.1016/j.eurox.2025.100393
Ibu, U., Paritas, D. A. N., Dengan, B., & Dini, K. P. (2025). Jurnal sains kebidanan. 7(2), 64–71. https://doi.org/10.31983/jsk.v7i2.13447
Jiang, Y., Zhang, Y., Li, Y., Zhao, K., Zhao, Y., & Che, Y. (2025). Determinants for premature rupture of membranes : a prospective cohort study.
Journal, T., & Of, H. (2024). Ketuban pecah dini. 1(1), 1–5.
Karabay, G., Bayraktar, B., Seyhanli, Z., Cakir, B. T., & Aktemur, G. (2024). Predictive value of inflammatory markers ( NLR , PLR , MLR , SII , SIRI , PIV , IG , and MII ) for latency period in Preterm premature rupture of membranes ( PPROM ) pregnancies.
Katz, A. A., Segal, E., Kashani-ligumsky, L., Many, A., & Lopian, M. (2025). Is there a role for oral misoprostol in labor induction for prelabor rupture of membranes at term ?
Liu, X., Si, S., Huang, L., Zhang, M., Chen, W., Wang, L., & Yu, Y. (2023). Vaginal flora during pregnancy and subsequent risk of preterm birth or prelabor rupture of membranes : a nested case – control study from China. BMC Pregnancy and Childbirth, 1–9. https://doi.org/10.1186/s12884-023-05564-y
Manurung, H. R. (2025). Implementasi BEST PRACTICE (H. R. Manurung (ed.)). Cv. AA .Rizky.
Müller, H., Stähling, A. C., Bruns, N., Weiss, C., Ai, M., Köninger, A., & Müser, U. F. (2022). Latency duration of preterm premature rupture of membranes and neonatal outcome : a retrospective single ‑ center experience. European Journal of Pediatrics, 801–811. https://doi.org/10.1007/s00431-021-04245-2
Sinaga, S. N. (2022). The Relationship of the Quality Dimensions of Antenatal Care Services with the Satisfaction of Pregnant Women in Trimester Iii in the Work Area in the Hutabayu Puskesmas , Simalungun Regency in 2022. 9(2), 571–577.
Starrach, T., Ehmann, L., Volkmann, H., Flemmer, A., Hester, A., Tremmel, E., Beyer, S., Hertlein, L., Hübener, C., Hornung, R., Kolben, T., Mahner, S., & Büchel, J. (2025). PROM at term : when might be the best time to induce labour ? A retrospective analysis. Archives of Gynecology and Obstetrics, 312(1), 247–255. https://doi.org/10.1007/s00404-025-07981-0
Surbakti, I. S., Batubara, Z., Simanullang, E., Muliana, S., Bakara, P., Lestari, D. C., & Utami, D. J. (2026). Optimalisasi Karakter Generasi Emas , Maturitas melalui Core Value PACER ( Profesional , Akuntabel , Collaboration , Empaty and Reliable ) Rejo Kecamatan Tanjung Morawa. 5(1), 1021–1030.
Turlina, L., & Ummah, F. (2020). Risk Factors for Premature Rupture. https://doi.org/10.21070/midwiferia.v
Winata, I. G. S., Mahendrata, P., Agung, A., Kusumadewi, R., Afifah, M., Anwar, N., & Nathalia, J. (2025). Antioxidant administration on the incidence of preterm premature rupture of membranes : a literature review. 6(1), 1–3. https://doi.org/10.51559/inajperinatol.v6i1.75
Xiao, S., & Lin, M. (2025). Clinical characteristics and risk factors of premature rupture of membranes infection in pregnant and lying-in women. SLAS Technology, 33(June), 100320. https://doi.org/10.1016/j.slast.2025.100320
Yan, C., Deng, X., & Hong, F. (2022). Analysis of Maternal and Neonatal Outcome of Patients with Preterm Prelabor Rupture of Membranes. 2022.
Yan, C., Hong, F., Xin, G., & Duan, S. (2022). Alterations in the vaginal microbiota of patients with preterm premature rupture of membranes. August, 1–11. https://doi.org/10.3389/fcimb.2022.858732
Abebe, T. A., Nima, D. D., Mariye, Y. F., & Leminie, A. A. (2022). preterm premature rupture of. December, 1–13. https://doi.org/10.3389/frph.2022.1052827
Astuti, D. W., Kebidanan, A., & Husada, R. (2023). Karakteristik ibu bersalin dengan kejadian ketuban pecah dini. 8(1).
Che, A., Si, S., & Liu, J. (2025). Efficacy and safety of misoprostol versus oxytocin for labor induction in women with prelabor rupture of membranes : a meta- analysis.
Dayanan, R., Bayraktar, B., Karabay, G., Filiz, A. A., & Tonyali, N. V. (2025). Prognostic evaluation of albumin-associated inflammatory indices ( LAR , NAR , MAR , FAR , SII / Alb , SIRI / Alb , NPAR , and CAR ) in preterm premature rupture of membranes ( PPROM ) pregnancies. 6.
Di, P., Stella, R., & Medan, M. (2023). No Title. 1(1).
Duangkum, C., Pattamathamakul, S., Chaiyarach, S., Sawanyawisuth, K., Chantanaviliai, S., & Pongsamakthai, M. (2025). European Journal of Obstetrics & Gynecology and Reproductive Biology : X Predictors of delivery at 48 hours or more in pregnant women with preterm prelabor rupture of membrane : A retrospective cohort study. European Journal of Obstetrics & Gynecology and Reproductive Biology: X, 26(January), 100393. https://doi.org/10.1016/j.eurox.2025.100393
Ibu, U., Paritas, D. A. N., Dengan, B., & Dini, K. P. (2025). Jurnal sains kebidanan. 7(2), 64–71. https://doi.org/10.31983/jsk.v7i2.13447
Jiang, Y., Zhang, Y., Li, Y., Zhao, K., Zhao, Y., & Che, Y. (2025). Determinants for premature rupture of membranes : a prospective cohort study.
Journal, T., & Of, H. (2024). Ketuban pecah dini. 1(1), 1–5.
Karabay, G., Bayraktar, B., Seyhanli, Z., Cakir, B. T., & Aktemur, G. (2024). Predictive value of inflammatory markers ( NLR , PLR , MLR , SII , SIRI , PIV , IG , and MII ) for latency period in Preterm premature rupture of membranes ( PPROM ) pregnancies.
Katz, A. A., Segal, E., Kashani-ligumsky, L., Many, A., & Lopian, M. (2025). Is there a role for oral misoprostol in labor induction for prelabor rupture of membranes at term ?
Liu, X., Si, S., Huang, L., Zhang, M., Chen, W., Wang, L., & Yu, Y. (2023). Vaginal flora during pregnancy and subsequent risk of preterm birth or prelabor rupture of membranes : a nested case – control study from China. BMC Pregnancy and Childbirth, 1–9. https://doi.org/10.1186/s12884-023-05564-y
Manurung, H. R. (2025). Implementasi BEST PRACTICE (H. R. Manurung (ed.)). Cv. AA .Rizky.
Müller, H., Stähling, A. C., Bruns, N., Weiss, C., Ai, M., Köninger, A., & Müser, U. F. (2022). Latency duration of preterm premature rupture of membranes and neonatal outcome : a retrospective single ‑ center experience. European Journal of Pediatrics, 801–811. https://doi.org/10.1007/s00431-021-04245-2
Sinaga, S. N. (2022). The Relationship of the Quality Dimensions of Antenatal Care Services with the Satisfaction of Pregnant Women in Trimester Iii in the Work Area in the Hutabayu Puskesmas , Simalungun Regency in 2022. 9(2), 571–577.
Starrach, T., Ehmann, L., Volkmann, H., Flemmer, A., Hester, A., Tremmel, E., Beyer, S., Hertlein, L., Hübener, C., Hornung, R., Kolben, T., Mahner, S., & Büchel, J. (2025). PROM at term : when might be the best time to induce labour ? A retrospective analysis. Archives of Gynecology and Obstetrics, 312(1), 247–255. https://doi.org/10.1007/s00404-025-07981-0
Surbakti, I. S., Batubara, Z., Simanullang, E., Muliana, S., Bakara, P., Lestari, D. C., & Utami, D. J. (2026). Optimalisasi Karakter Generasi Emas , Maturitas melalui Core Value PACER ( Profesional , Akuntabel , Collaboration , Empaty and Reliable ) Rejo Kecamatan Tanjung Morawa. 5(1), 1021–1030.
Turlina, L., & Ummah, F. (2020). Risk Factors for Premature Rupture. https://doi.org/10.21070/midwiferia.v
Winata, I. G. S., Mahendrata, P., Agung, A., Kusumadewi, R., Afifah, M., Anwar, N., & Nathalia, J. (2025). Antioxidant administration on the incidence of preterm premature rupture of membranes : a literature review. 6(1), 1–3. https://doi.org/10.51559/inajperinatol.v6i1.75
Xiao, S., & Lin, M. (2025). Clinical characteristics and risk factors of premature rupture of membranes infection in pregnant and lying-in women. SLAS Technology, 33(June), 100320. https://doi.org/10.1016/j.slast.2025.100320
Yan, C., Deng, X., & Hong, F. (2022). Analysis of Maternal and Neonatal Outcome of Patients with Preterm Prelabor Rupture of Membranes. 2022.
Yan, C., Hong, F., Xin, G., & Duan, S. (2022). Alterations in the vaginal microbiota of patients with preterm premature rupture of membranes. August, 1–11. https://doi.org/10.3389/fcimb.2022.858732
Abebe, T. A., Nima, D. D., Mariye, Y. F., & Leminie, A. A. (2022). preterm premature rupture of. December, 1–13. https://doi.org/10.3389/frph.2022.1052827
Astuti, D. W., Kebidanan, A., & Husada, R. (2023). Karakteristik ibu bersalin dengan kejadian ketuban pecah dini. 8(1).
Che, A., Si, S., & Liu, J. (2025). Efficacy and safety of misoprostol versus oxytocin for labor induction in women with prelabor rupture of membranes : a meta- analysis.
Dayanan, R., Bayraktar, B., Karabay, G., Filiz, A. A., & Tonyali, N. V. (2025). Prognostic evaluation of albumin-associated inflammatory indices ( LAR , NAR , MAR , FAR , SII / Alb , SIRI / Alb , NPAR , and CAR ) in preterm premature rupture of membranes ( PPROM ) pregnancies. 6.
Di, P., Stella, R., & Medan, M. (2023). No Title. 1(1).
Duangkum, C., Pattamathamakul, S., Chaiyarach, S., Sawanyawisuth, K., Chantanaviliai, S., & Pongsamakthai, M. (2025). European Journal of Obstetrics & Gynecology and Reproductive Biology : X Predictors of delivery at 48 hours or more in pregnant women with preterm prelabor rupture of membrane : A retrospective cohort study. European Journal of Obstetrics & Gynecology and Reproductive Biology: X, 26(January), 100393. https://doi.org/10.1016/j.eurox.2025.100393
Ibu, U., Paritas, D. A. N., Dengan, B., & Dini, K. P. (2025). Jurnal sains kebidanan. 7(2), 64–71. https://doi.org/10.31983/jsk.v7i2.13447
Jiang, Y., Zhang, Y., Li, Y., Zhao, K., Zhao, Y., & Che, Y. (2025). Determinants for premature rupture of membranes : a prospective cohort study.
Journal, T., & Of, H. (2024). Ketuban pecah dini. 1(1), 1–5.
Karabay, G., Bayraktar, B., Seyhanli, Z., Cakir, B. T., & Aktemur, G. (2024). Predictive value of inflammatory markers ( NLR , PLR , MLR , SII , SIRI , PIV , IG , and MII ) for latency period in Preterm premature rupture of membranes ( PPROM ) pregnancies.
Katz, A. A., Segal, E., Kashani-ligumsky, L., Many, A., & Lopian, M. (2025). Is there a role for oral misoprostol in labor induction for prelabor rupture of membranes at term ?
Liu, X., Si, S., Huang, L., Zhang, M., Chen, W., Wang, L., & Yu, Y. (2023). Vaginal flora during pregnancy and subsequent risk of preterm birth or prelabor rupture of membranes : a nested case – control study from China. BMC Pregnancy and Childbirth, 1–9. https://doi.org/10.1186/s12884-023-05564-y
Manurung, H. R. (2025). Implementasi BEST PRACTICE (H. R. Manurung (ed.)). Cv. AA .Rizky.
Müller, H., Stähling, A. C., Bruns, N., Weiss, C., Ai, M., Köninger, A., & Müser, U. F. (2022). Latency duration of preterm premature rupture of membranes and neonatal outcome : a retrospective single ‑ center experience. European Journal of Pediatrics, 801–811. https://doi.org/10.1007/s00431-021-04245-2
Sinaga, S. N. (2022). The Relationship of the Quality Dimensions of Antenatal Care Services with the Satisfaction of Pregnant Women in Trimester Iii in the Work Area in the Hutabayu Puskesmas , Simalungun Regency in 2022. 9(2), 571–577.
Starrach, T., Ehmann, L., Volkmann, H., Flemmer, A., Hester, A., Tremmel, E., Beyer, S., Hertlein, L., Hübener, C., Hornung, R., Kolben, T., Mahner, S., & Büchel, J. (2025). PROM at term : when might be the best time to induce labour ? A retrospective analysis. Archives of Gynecology and Obstetrics, 312(1), 247–255. https://doi.org/10.1007/s00404-025-07981-0
Surbakti, I. S., Batubara, Z., Simanullang, E., Muliana, S., Bakara, P., Lestari, D. C., & Utami, D. J. (2026). Optimalisasi Karakter Generasi Emas , Maturitas melalui Core Value PACER ( Profesional , Akuntabel , Collaboration , Empaty and Reliable ) Rejo Kecamatan Tanjung Morawa. 5(1), 1021–1030.
Turlina, L., & Ummah, F. (2020). Risk Factors for Premature Rupture. https://doi.org/10.21070/midwiferia.v
Winata, I. G. S., Mahendrata, P., Agung, A., Kusumadewi, R., Afifah, M., Anwar, N., & Nathalia, J. (2025). Antioxidant administration on the incidence of preterm premature rupture of membranes : a literature review. 6(1), 1–3. https://doi.org/10.51559/inajperinatol.v6i1.75
Xiao, S., & Lin, M. (2025). Clinical characteristics and risk factors of premature rupture of membranes infection in pregnant and lying-in women. SLAS Technology, 33(June), 100320. https://doi.org/10.1016/j.slast.2025.100320
Yan, C., Deng, X., & Hong, F. (2022). Analysis of Maternal and Neonatal Outcome of Patients with Preterm Prelabor Rupture of Membranes. 2022.
Yan, C., Hong, F., Xin, G., & Duan, S. (2022). Alterations in the vaginal microbiota of patients with preterm premature rupture of membranes. August, 1–11. https://doi.org/10.3389/fcimb.2022.858732
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