What symptom indicates a possible maternal infection in a patient with PROM?

Abdominal tenderness is a significant symptom that can indicate a possible maternal infection in a patient with premature rupture of membranes (PROM). When the membranes rupture, there is an increased risk of infection for both the mother and the fetus, particularly if there is prolonged exposure to the environment. Abdominal tenderness can suggest an underlying inflammatory process or infection, such as chorioamnionitis, which is an infection of the amniotic fluid and membranes. This condition is associated with complications like fever, increased heart rate, and uterine tenderness.

Other symptoms listed, such as increased fetal movement, severe headaches, and low back pain, are not specifically indicative of maternal infection in the context of PROM. Increased fetal movement might suggest fetal well-being, while severe headaches can arise from various causes not directly related to infection. Low back pain is common in pregnancy for many reasons and is not a reliable indicator of infection. Thus, abdominal tenderness stands out as a critical symptom warranting further investigation for a possible maternal infection in cases of PROM.