Preterm premature rupture of membranes Flashcards

1
Q

What is the difference between PROM and PPROM?

A

PROM - premature rupture of membranes: >37w gestation presenting w ROM prior to onset of labour
PPROM - preterm premature rupture of membranes: ROM <37w before onset of labour

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2
Q

What are causes of PROM

A

Mostly unknown

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3
Q

When is conservative management appropriate?

A

up to 24hr post membrane rupture if the liquor is clear, mum well and no fatal concerns

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4
Q

When should IOL occur

A

if spontaneous labour hasn’t commenced by 24hr

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5
Q

What is given for IOL

A

Vaginal prostaglandin E2 gel for 6 hr followed by an oxytocin infusion if contractions haven’t started

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6
Q

When are prophylactic abx indicated

A

if clinical evidence of infection

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7
Q

what infection must be covered if prophylactic abx is used

A

GBS

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8
Q

What are indications for immediate IOL?

A
GBS carriers 
HIV carriers 
signs of chorioamnionitis
concerns of fetal movements 
meconium stained liquor 
herpes simplex inf.
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9
Q

What is a risk to the neonate of PROM

A

INFECTION so monitor observations

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10
Q

What are the complications of PPROM

A

prematurity
infection
pulmonary hyperplasia
chorioamnionitis (mum)

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11
Q

Why should digital examination be avoided in PPROM

A

Risk of infection

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12
Q

What is the management of PPROM

A
Admit
look out for chorioamnionitis
oral erythromycin (10days)
corticosteroids (ARDS)
consider deliver at 34 weeks
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