Prelabour Rupture of Membranes at Term Flashcards
What is classed as premature?
Risk factors - list a few
Being born <37 wks
Previous preterm birth Multiple pregnancies Cervical surgery (LLETZ or cone biopsy) Uterine anomalies Pre-existing medical conditions PET IUGR
What are some complications if a PROM doesn’t progress to labour? - 2 - think pathogens passing through to the amniotic fluid
60% progress to labour within 24 hrs
Chorioamnionitis
Neonatal sepsis
Discharge:
- Colour
- What may it be compared to?
- How would women notice it?
Clear
Watery
Wet underwear or pads
Investigations:
- Why may a speculum be done?
- What should be checked if premature? - 2
Only if there is uncertainty in the history
Fetal fibronectin and HVS (High vaginal swab)
Fetal monitoring:
- What is used to monitor HR?
- What can the mum also do?
Conservative management:
- When can this type of management be done?
- What signs of change should the mum be looking out for what would warrant admission
- What should mum avoid to prevent infection?
CTG
Monitor fetal movements
If the mother well
Liquor clear
No fetal concerns
Change in fetal movements
Change in colour or smell of liquor
Avoid sexual intercourse
Induction of labour:
- How long after PROM should induction be done?
- What is inserted into the vagina to induce labour? - P
- What infusion can be given if labour still doesn’t start? - O
- What may be needed for the baby after delivery?
- What is given if there is a suspected infection?
- What should be done to test for infection before above is done?
What if induction if refused?
> 24 hrs
Prostaglandin
Oxytocin
Neonatal care facilities - SCBU
Prophylactic antibiotics - make sure GBS is covered for
Offer advice
Fetal monitoring every 24 hours while not in the labour
Monitor fetal heart rate on 1st visit
Mum should watch out for changes in fetal movement
Indications for immediate induction of labour - list some
GBS carriers HIV carriers Signs of chorioamnionitis Reduced fetal movements Meconium-stained liquor Herpes simplex virus
