C-Obs 36 Term PROM

Question 1

What can cause false positives on Amnisure or testing for presence amniotic fluid proteins in vaginal fluid?

Answer 1

Blood
Semen
Alkaline antiseptics
Certain lubricants
Trichomoniasis
Bacterial vaginosis 

False positives of up to 19-130%

Question 2

Immediate risks of rupture membranes

Answer 2

Cord prolapse
cord compression
placental abruption

Question 3

What percentage of pregnancies are TERM PROM and how long does it take to deliver ?

Answer 3

8% term PROM

70% within 24
85% within 48
95% within 96

Question 4

Delayed risks term prom

Answer 4

Maternal infection

Neonatal infecton: death, chronic lung disease, cerebral palsy

Question 5

Findings from 2017 Cochrane

Answer 5

Reduced NN sepsis RR 0.73
Reduced NN abx RR 0.61
Reduced nicu admission RR 0.75
Reduced chorion RR 0.49

Reduced CS but NS finding

Question 6

Requirements for expectant management

Answer 6

Fixed cephalic
-ve GVS, no prior hx of baby w GBS
No signs infection (tachy, fever, tender)
N CTG + mvmt
Clear amniotic fluid
Adequate resourcing 
Commitment to regular assess mat temp, vag loss, mvmts (4 hourly)
Acess to transport
Clearly documented plan for review