PPROM Flashcards

1
Q

What is the incidence of PPROM?

A

3%

RCOG

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2
Q

PPROM is associated with _______ of preterm births

A

30-40%

RCOG

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3
Q

What is the median latency after PPROM?

A

7 days

RCOG

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4
Q

What are the benefits of erythromycin in the context of PPROM?

A

Reduced Chorioamnionitis
Prolonged latency
Improved neonatal outcomes

RCOG

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5
Q

Is tocolysis recommended in PPROM?

A

No

Cochrane review found that

  • tocolysis does not significantly improve perinatal outcome and might be associated with an increased risk of chorioamnionitis
  • tocolysis was associated with an increased risk of APGAR <7 and the need for ventilation support
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6
Q

With PPROM, what is the delivery latency from

24-28/40
31/40

A

24-28/40: 8-10 days

31/40: 5 days

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7
Q

With PPROM, what are three risk factors for complications

Fetal death, placental abruption, umbilical cord prolapse, delivery outside of hospital, neonatal death

A

PPROM <26/40
Non-cephalic presentation
Oligohydramnios

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8
Q

What does Amnisure test for?

A

Placental Micro Globulin PAMG-1

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9
Q

What are the complications of PPROM?

A
Prematurity
Sepsis (Chorioamnionitis)
Cord prolapse
Placental abruption 
Pulmonary hypoplasia
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10
Q

Why is increased emotional support required in PPROM?

A

Increased rate of PTSD

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11
Q

What were the findings of the Cochrane review on amnio infusion with PPROM?

A

Associated with improved outcomes in

  • fetal umbilical artery pH at delivery
  • variable decelerations in labour
  • neonatal death
  • neonatal sepsis
  • pulmonary hypoplasia
  • puerperal sepsis

BUT insufficient data: further evidence required.
NOT currently recommended as part of routine clinical practice

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12
Q

What antibiotic should be used in PPROM, if a woman is allergic to erythromycin?

A

Penicillin

NICE guideline

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