Document ID: ./input/supremecourt_opinions/opinions/23pdf/23-726_6jgm.pdf
Page Number: 43.0

20 

MOYLE v. UNITED STATES 

ALITO, J., dissenting 

complications  are  not  inevitable,  and  according  to  the
PPROM Foundation, death is “extremely rare.”20  A physi-
cian may try to delay labor by putting the woman on bed 
rest  and  administering  steroids  to  help  the  baby’s  lungs
grow and antibiotics to prevent infection.21 

When PPROM occurs before the 24th week of pregnancy, 
the potential for conflict appears to be even higher.  But in 
that situation, it may still be possible to manage the situa-
tion until the baby can be delivered,22 and there is a chance 
of a good outcome for both the mother and child, although
studies  have  yielded  different  results.23  Thus,  when 

—————— 
of studies after 1993 indicated that the most common maternal morbidity
is infection of the amniotic fluid, “with approximately 37% of women de-
veloping this complication.”  T. Waters & B. Mercer, The Management of 
Preterm Premature Rupture of Membranes Near the Limit of Fetal Via-
bility, Am. J. Obstetrics & Gynecology (AJOG), p. 231 (Sept. 2009); see
also Brief for Physicians for Reproductive Health as Amicus Curiae 18. 

20 PPROM  Foundation,  PPROM  Facts,  https://www.aapprom. 

org/community/ppromfacts (June 21, 2024) (PPROM Facts). 

21 Ibid.; see also Children’s Hospital of Philadelphia, Premature Rup-
ture of Membranes (PROM)/Preterm Premature Rupture of Membranes
(PPROM),  https://www.chop.edu/conditions-diseases/premature-rupture-
membranes-prompreterm-premature-rupture-membranes-pprom  (June 
21, 2024). 

22 See,  e.g.,  S.  Dayal  &  P.  Hong,  Premature  Rupture  of  Membranes

(July 17, 2023), https://www.ncbi.nlm.nih.gov/books/NBK532888. 

23 “A  recent  study  reports  a  90%  survival  rate  for  infants  exposed  to
prolonged PPROM occurring between 18–24 weeks who were delivered
after  24  weeks.”    PPROM  Facts  (citing  J.  Brumbaugh  et al.,  Neonatal
Survival After Prolonged Preterm Premature Rupture of Membranes Be-
fore 24 Weeks of Gestation, 124 Obstetrics & Gynecology 992 (2014); see 
also  A.  Ozel  et al.,  Outcomes  of  Pregnancies  Complicated  by  Preterm 
Premature  Rupture  of  Membranes  Before  and  After  24  Gestational 
Weeks: A Retrospective Analysis, J. Clinical Obstetrics & Gynecology, p. 
231  (Nov.  2023)  (reporting  that  one-third  of  unborn  children  survived 
PPROM  before  viability  at  a  hospital  between  2018–2020);  E.  Lorthe 
et al.,  Preterm  Premature  Rupture  of  Membranes  and  22–25  Weeks’ 
Gestation, AJOG, p. 5 (Sept. 2018) (determining that, when PPROM oc-
curred between weeks 22 and 25, about half of the children survived, and 
roughly three-quarters of the survivors did not have severe morbidities);