Preterm premature rupture of membranes Flashcards
What is the difference between PROM and PPROM?
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
What are causes of PROM
Mostly unknown
When is conservative management appropriate?
up to 24hr post membrane rupture if the liquor is clear, mum well and no fatal concerns
When should IOL occur
if spontaneous labour hasn’t commenced by 24hr
What is given for IOL
Vaginal prostaglandin E2 gel for 6 hr followed by an oxytocin infusion if contractions haven’t started
When are prophylactic abx indicated
if clinical evidence of infection
what infection must be covered if prophylactic abx is used
GBS
What are indications for immediate IOL?
GBS carriers HIV carriers signs of chorioamnionitis concerns of fetal movements meconium stained liquor herpes simplex inf.
What is a risk to the neonate of PROM
INFECTION so monitor observations
What are the complications of PPROM
prematurity
infection
pulmonary hyperplasia
chorioamnionitis (mum)
Why should digital examination be avoided in PPROM
Risk of infection
What is the management of PPROM
Admit look out for chorioamnionitis oral erythromycin (10days) corticosteroids (ARDS) consider deliver at 34 weeks