PPROM Flashcards
What is PPROM
Premature Prelabour Rupture of Membranes
so ruptured membranes before 37 weeks with no uterine contractions
When do PPROM women go on to deliver
50% of women deliver within 7 days
What are RF for PPROM
Prior PPROM/PTB
APH
Infection (urinary, STI, BV)
Low BMI
How do you approach managing PPROM based on gestation
<34 weeks: conservative, unless evidence of chorioamnionitis
Immediate IOL if >37
what is conservative mx for PPROM
admit for min 48 hours
Prescribe antenatal corticosteroids and antibiotics (erythromycin 10 days)
Regular obs
Consider delivery at 34 wks
What kind of surveillance ix must you perform in woman admitted with PPROM
Intense clinical surveillance: temp, HR, CTG, maternal WCC, CRP
Lower genital tract swabs
why is tocolysis contraindicated in PPROM
increased risk of maternal and foetal infection
what are complicatioons of PPROM
foetal: prematurity, infection (sepsis), pulmonary hypoplasia
maternal: chorioamnionitis
How do you investigate a woman coming in with suspected pprom
History
Speculum (liquor pool in post vaginal vault)
if speculum negative: insulin like growth factor binding protein 1 OR alpha-microglobulin 1 test
If negative: unlikely to have pprom
What is the dose of ABx you give for pprom
10 days erythromycin 250mg qds for max 10 days or until woman is in established labour (whichever is sooner)
What are signs of chorioamnionitis
Offensive liquor
Yellow green liquor
Tender. uterus
Maternal tachycardia, tachypnoea, high temp
Maternal CRP, WCC raised
why should you NEVER give co amoxiclav in a woman with PPROM
can cause necrotising enterocolitis
