PPROM Flashcards
What is the incidence of PPROM?
3%
RCOG
PPROM is associated with _______ of preterm births
30-40%
RCOG
What is the median latency after PPROM?
7 days
RCOG
What are the benefits of erythromycin in the context of PPROM?
Reduced Chorioamnionitis
Prolonged latency
Improved neonatal outcomes
RCOG
Is tocolysis recommended in PPROM?
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
With PPROM, what is the delivery latency from
24-28/40
31/40
24-28/40: 8-10 days
31/40: 5 days
With PPROM, what are three risk factors for complications
Fetal death, placental abruption, umbilical cord prolapse, delivery outside of hospital, neonatal death
PPROM <26/40
Non-cephalic presentation
Oligohydramnios
What does Amnisure test for?
Placental Micro Globulin PAMG-1
What are the complications of PPROM?
Prematurity Sepsis (Chorioamnionitis) Cord prolapse Placental abruption Pulmonary hypoplasia
Why is increased emotional support required in PPROM?
Increased rate of PTSD
What were the findings of the Cochrane review on amnio infusion with PPROM?
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
What antibiotic should be used in PPROM, if a woman is allergic to erythromycin?
Penicillin
NICE guideline