Premature Rupture of Membrane

Question 1

1.) Spontaneous rupture of the membranes prior to
the onset of labor. After 37 weeks

2.) before 37 wks. gestation

Answer 1

1.) PROM
2.) PPROM

Question 2

A test to check if a woman’s
water has broken, using a special paper that
changes color when exposed to amniotic fluid

■ Blue: (+) Presence of amniotic fluid
[PROM]

■ Yellow/Green: (-) Amniotic fluid; Urine
only

Answer 2

Nitrazine test

Question 2

RISK FACTORS

Answer 2

● Infection (Cervicitis)
○ Inflammation of the cervix, often caused by
infection

● Previous history of PROM
● Hydramnios
● Multiple pregnancy
● Urinary Tract Infection (UTI)

Question 2

ASSESSMENT

Answer 2

The fetus should be delivered within 24 hours
after PROM to prevent infection

● Observe the mother for s/s of infection:
○ WBC count
○ Temperature (+fever = check hydration)
○ PR
○ Character of amniotic fluid

Question 3

MATERNAL IMPLICATIONS

Answer 3

● Infection
○ Chorioamnionitis
■ Infection of the amniotic fluid

○ Endometritis
■ Infection of the endometrium

Question 4

A test where a sample of vaginal fluid
is examined under a microscope for a fern-like
pattern, indicating amniotic fluid

■ Forms a fern pattern: (+) Presence of
amniotic fluid [PROM]

● Note: NO Digital exam

Answer 4

Fern test

Question 5

COLLABORATIVE CARE

Answer 5

● Q4H:
○ Maternal BP, pulse and temperature
○ FHR

Single dose of betamethasone for PROM prior to
30-32 weeks’ gestation, if there is no intra-amniotic
infection

(+) Streptococcus B need intravenous
administration of penicillin or ampicillin

For mature fetus with (-) labor = administration of
oxytocin

Question 6

Why should engaging in sexual intercourse be refrained?

Answer 6

1. Climax (orgasm) → Releases oxytocin
2. Semen contains prostaglandins → Can soften the
   cervix

**both can INDUCE labor