8 - Obs - Preterm Delivery - Preterm Prelabour ROM Flashcards
membrane rupture weeks
occurs before ?/3rd of preterm deliveries
37
1/3rd
Complx:
? ? is principal compx, follows within 48h in >?% cases. Infection of ? or placenta (?) or cord (?) common. May occur before and be the ?, or may follow ?. ? of umbilical cord may occur rarely. Absence of ? (<24 wks) can lead to pulm ? and ?
deformities
preterm delivery >50% fetus chorioamnionitis funisitis cause rupture prolapse liquor hypoplasia postural
Clinical Features:
Hx: Gush of ? fluid, followed by further ?.
Ex: ? and ? checked. Pool of fluid in ? ? on speculum ex is ?, but not invariable. VE ?
though can be done to r/o cord ? if presx not ?. Chorioamnionitis characterized by ? or ? pain, fever, ?, uterine ? and ?
offensive liquor. Clinical signs often ?.
clear leaking lie presx posterior fornix diagnostic avoided prolapse cephalic contractions abdo tachycardia tenderness coloured late
Ix
To confirm diagnosis: ??? may show reduced ?, but volume can be normal as fetal ?
production continues.
To look for infection: ? vaginal swab, ???, ???. If in doubt, ? w gram staining and ? can be used.
Fetal Well-being: CTG. Persistent fetal ? = infection.
USS
liquor
uterine
high CRP FBC amniocentesis culture
tachycardia
MGMT
Risk of preterm ? balanced vs risk of ?– if present, greatly incr fetal ? and ?-? morb. Prevention and ID ?. Woman admitted and given ?. Close maternal and fetal ?, if gestation reaches 36wks > ?.
delivery infection mort long-term essential steroids surveillance induce
MGMT
Identification and Management of Infection
Early ? has few signs. If evidence, ?? Abx given ? and fetus ?, Abx alone won’t eliminate.
Prevention of Infection
Prophylactic use of ? in women without clinical evidence is usual. ?-? contraindicated as neonate more prone to ???.
chorioamnionitis
IV
immediately
delivered
erythromycin
co-amox
NEC
