L7: PROM

Question 1

Def of PROM

Answer 1

• ROM before onset of labor after 37 weeks gestation.

Question 2

Def of PPROM

Answer 2

• ROM before 37 weeks gestation = between 20-37 w.

Question 3

Def of Early ROM

Answer 3

ROM during 1st stage of labor

Question 4

Incidence of PROM

Answer 4

2% of all pregnancies

Question 5

Etiology & RF for PROM

Answer 5

Question 6

Etiology & RF for PROM

• Idiopathic

Answer 6

…

Question 7

Etiology & RF for PROM

• Genital Infection

Answer 7

bacterial vaginosis

Question 8

Etiology & RF for PROM

• Trauma

Answer 8

Direct or coital trauma

Question 9

Etiology & RF for PROM

• Congenital Weakness in Membrane

Answer 9

Affects its tensile strength.

Question 10

Etiology & RF for PROM

• Increased Intrauterine Presssure

Answer 10

• polyhydramnios, placental abruption & multifetal pregnancy.

Question 11

Etiology & RF for PROM

• Malpresentation & Malposition

Answer 11

…

Question 12

Etiology & RF for PROM

• Other RF

Answer 12

• Previous PROM
• Previous preterm labor
• Uterine anomalies
• Smoking
• Malnutrition
• Low SES

Question 13

Complications of PROM

Answer 13

Question 14

Chorioamnionitis in PROM

• Significance

Answer 14

Most serious complication

Question 15

Chorioamnionitis in PROM

• Symptoms

Answer 15

Fever, Rigors, Abdominal pain & Foul odor of fluid.

Question 16

Chorioamnionitis in PROM

• Signs

Answer 16

1) Maternal: Fever, tachycardia, uterine tenderness & offensive vaginal discharge,

2) Fetal: Fetal tachycardia (earliest sign).

Question 17

Chorioamnionitis in PROM

• INVx

Answer 17

1) CBC: Leukocytosis.

2) C-reactive protein (CRP): 1

3) AF analysis: Leukocytosis & organisms,

4) AF culture & sensitivity testing.

Question 18

Coed Prolapse in PROM

Answer 18

Specially in polyhydramnios or malpresentation.

Question 19

Premature Placental Separation in PROM

Answer 19

Specially in polyhydramnios.

Question 20

Fetal Compression Syndrome in PROM

Question 21

Fetal Compression Syndrome in PROM

• Etiology

Answer 21

Drainage of liquor.

Question 22

Fetal Compression Syndrome in PROM

• Characters

Answer 22

Pulmonary hypoplasia, abnormal facies , contracture of extremities

Question 23

Dx of PROM

Answer 23

Question 24

Dx of PROM

• Hx

Question 25

Dx of **PROM** - Ex

Question 26

Dx of **PROM** - General Ex

Question 27

Dx of **PROM** - Abdominal Ex

Question 28

Dx of **PROM** - Local Ex

Question 29

Dx of **PROM** - INVx

Question 30

INVx in **PROM**

Question 31

INVx in **PROM** - Confirmation of nature of fluid

Question 32

INVx in **PROM** - Nitrazine Strip test

Question 33

INVx in **PROM** - Fernig Test

Question 34

INVx in **PROM** - Nile Blue Sulphate

Question 35

INVx in **PROM** - Evaluation of Fetal Wellbeing

Question 36

INVx in **PROM** - detection of Infection

Question 37

Prevention of **PROM**

Question 38

TTT of **PROM**

Question 39

TTT of **PROM** - Plan of TTT

Question 40

Plan of TTT of **PROM** - If there is infection

Question 41

Plan of TTT of **PROM** - If there is no infection

Question 42

TTT of **PROM** if **NO** Infection - Mature Fetus + Uterine Activity

Question 43

TTT of **PROM** if **NO** Infection - Mature Fetus + No Uterine Activity

Question 44

TTT of **PROM** if **NO** Infection - Immature Fetus + Uterine activity

Question 45

TTT of **PROM** if **NO** Infection - Immature Fetus + No Uterine Activity

Question 46

Lines of TTT in **PROM**

Question 47

Expectant TTT of **PROM** - Hospitalization

Question 48

Expectant TTT of **PROM** - Rest

Question 49

Expectant TTT of **PROM** - Avoid Vaginal Examination

Question 50

Expectant TTT of **PROM** - Observation

Question 51

Expectant TTT of **PROM** - Drugs

Question 52

TOP in **PROM** - Indications

Question 53

TOP in **PROM** - Methods