Mehl. PROM vs PPROM + tests to Dx 02-20 (1) Flashcards
Premature rupture of membranes (PROM) definition?
rupture of the amniotic sac prior to labor >37 weeks.
Preterm premature rupture of membranes (PPROM), definition?
PROM <37 weeks.
Can be confirmed through various tests? 3
pooling of fluid,
nitrazine paper test,
microscopic examination of vaginal secretions for ferning.
PROM and PPROM bear increased risk for what? under what condition?
Bear increased infection risk if prolonged >18 hours;
PROM and PPROM bear increased infection risk. Prophylaxis?
Give prophylactic IV ampicillin, penicillin, or erythromycin.
PROM (i.e., 37 weeks or later) is usually treated with ……?
delivery, since fetus is already term.
PPROM is managed depending on …?
On how early it occurs, striking a balance between allowing for progression of gestational age vs infection risk.
The mindset of “each day matters” applies to fetal gestational development when the child is preterm.
If PPROM occurs <24 weeks, the pregnancy is usually maintained as long as…..?
As long as possible to achieve fetal
viability, followed by monitoring fetal activity and infection risk to achieve incr. gestational age.
Fetal fibronectin. definition?
Protein produced by the chorion of the placenta.
Acts as a “glue” attaching the chorion to the uterus.
Fetal fibronectin. Its presence in vaginal secretions between …… weeks, assoc. with what?
between 22 and 34 weeks of gestation is often
associated with a higher risk of preterm birth.
Fetal fibronectin. The test may be utilized to help predict the likelihood of?
of preterm labor delivering within the next week or two.
Fetal fibronectin. A (+) result indicates incr. risk;
a (-) result suggests decr. risk.
.
Nitrazine paper test. Used to detect presence of ….?
Of amniotic fluid in vaginal secretions; indicates ROM.
Nitrazine paper test. Nitrazine paper changes color in response to?
Nitrazine paper changes color in response to pH.
Nitrazine paper test. Normal vaginal pH is ?
Normal vaginal pH is acidic (4.5-6.0);
Nitrazine paper test. amniotic fluid pH is more?
amniotic fluid is more alkaline (>7.1).
Nitrazine paper test. When the Nitrazine paper comes into contact with amniotic fluid, it changes
from ….. color?
yellow/orange to blue.
Ferning pattern. Used to assess ?
ROM
Ferning pattern. how is performed?
Sample of vaginal fluid is viewed on light microscopy and observed for the characteristic pattern that resembles fern leaves once it has dried.
Ferning pattern. Fern-leaves pattern occurs why?
This crystallization pattern results from the presence of amniotic fluid that leaves behind salts dry in a distinctive feathery/fern-like pattern.
Ferning pattern. Used alongside with what test? Why?
Nitrazine test due to potential false-positives (i.e., low
specificity) arising from cervical mucus, which can also create a ferning pattern.
