Premature Rupture Of Membrane Flashcards
What is PROM
Leakage of amniotic fluid in the absence of labour irrespective of GA
PROM can be classified into three
Term Premature Rupture of Membrane
Preterm Premature Rupture of Membrane
Previable Premature Rupture of Membrane
The interval between rupture of membrane and onset of labor is called
Latency Interval
In preterm the incidence of PROM ranges from
40 to 60 percent
Mechanism of PROM
Infection
Biochemical factors: role of proteases and its inhibitors
Mechanical Stress: increased Intrauterine pressures may be due to polyhydraminos, multiple pregnancy
Inflammation
Cervical Factors
Causes of PROM
Maternal Infections
Intrauterine infections
Cervical incompetence
Multiple previous pregnancy
Polyhydraminos,
Nutritional deficit
Coitus
Familial history
Amniocentesis
Decreased tensile strength of membrane
Cervical Exam
Sterile Speculum Exam can help differentiate PROM from
Hydrorrhea gravidarum
Vaginitis
Urinary incontinence
Increased vaginal secretion
What is the Three confirmatory findings associated with PROM
Pooling: Amniotic fluid collection in the posterior fornix
Nitrazine test: Nitrazine paper turns blue demonstrating alkaline ph(7.0-7.25)
Ferning test: Vaginal secretions are looked under microscope for crystallization or ferning patterns
Treatment of PROM is dependent on
Gestational Age
Presence or Absence of chorioamnionitis
What are the complications of PROM
Infections
Infertility
Prematurity
Fetal death
What to ascertain In taking history in multiple pregnancy
Cessation of menses
Exaggerated pregnancy symptoms
Positive family hx of twinning
Use of ovulation induction drugs
IVF-ET
Advanced Maternal Age
Black race
What Investigative tool is used in the first trimester to confirm and classify twinning
Ultrasonography
