Obs: PTL and PPROM

Question 1

What are the option given to women with PTL

Answer 1

if present with Sx of PTL

Offer it to women either vaginal progesterone or cervical cerclage if-
hx of spontaneous preterm/mistrimester loss (16-34) AND whom TVUSS carried before 24w reveal cervix >25mm

offer progesterone if - no hx of spontaneous preterm/mid trim less, AND who has cervix >25mm

Question 2

How do you diagnose PPROM

Answer 2

Speculum Pools of fluid
TVUSS-oligohydramnios

IGFHB
FFN (fibronectin)

Question 3

How do you manage PPROM

Answer 3

Offer all women erythromycin for maximum 10d or until labour (allergy-peni)
Frequent monitoring for infections - best practice to admit after 28w +CTG

if <36w- steroids to be given
if before 30w, give IV MgSO4 in preterm labour