Premature rupture of membranes (PROM) refers to rupture of the fetal membranes before the onset of labour. When it occurs before 37 completed weeks of pregnancy, it is termed preterm premature rupture of membranes (PPROM). PROM is an important obstetric condition because it may lead to maternal and fetal complications, including infection, preterm birth, cord prolapse and fetal distress. Early recognition and appropriate referral at the primary health-care level are therefore essential. The woman may report a sudden gush or continuous leakage of clear, watery fluid from the vagina. The fluid may be difficult to distinguish from urine or normal vaginal discharge. At the primary health-care centre, a careful history should be taken regarding the time of onset, amount and colour of the fluid, uterine contractions, abdominal pain, fever, vaginal bleeding and fetal movements. The gestational age should also be established. General examination should include temperature, pulse, blood pressure and assessment for signs of infection or shock. Fetal heart