Prelabor Rupture Of Membranes

Question 1

Risk factors for PPROM

Answer 1

Short cervical length
Second and third trimester bleeding
Low BMI
Low socioeconomic status
Cigarette smoking and illicit drug use

Question 2

Complications of PPROM

Answer 2

Abruption
Infection
Pulmonary hypoplasia (<24w)

PTB complication:
RDS
SEPSIS
IVH
NEC

Question 3

Management of PROM at 37w and beyond

Answer 3

GBS ppx if indicated

Delivery

Question 4

Management 34-36+6

Answer 4

Expectant management or delivery
Single course of corticosteroids if not previously given
GBS screening and prophylaxis

Question 5

Management 23-33+6

Answer 5

Latency antibiotics
Corticosteroids
GBS cream
Mag sulfate less than 32 weeks

Question 6

Management Periviable

<23-24w

Answer 6

Expectant management or induction of labor
Antibiotics as early as 20 weeks
GBS prophylaxis 23 weeks and beyond
steroids 23 weeks and beyond mag sulfate 23 weeks in neon

Question 7

Latency antibiotics

Answer 7

Ampicillin 2g q6h IV and erythromycin 250 mg q6h
X48 hrs

Oral Amoxicillin 250 mg q8
Erythromycin base 333 mg q8h OR Azith 1g

Do not use Augmentin»>NEC

Question 8

Is tocolysis recommended for PPROM?

Answer 8

Ok for steroid benefit <34w Unless there is evidence of infection or abruption