PROM

Question 1

Define PROM

Answer 1

Premature rupture of membranes in absence of any uterine activity after 37wks gestation

Question 2

A lady who is 37+4 GA presents with fluid from vagina. She hasn’t felt any contractions. What are the next steps of management?

Answer 2

1. Admit to antenatal ward for sterile speculum examination

If amniotic fluid is CLEAR:
0-24hrs after ROM = expectant Mx. 60% will go into labour within 24hrs

> 24hrs after ROM = offer IOL

If MECONIUM -> IOL ASAP

2. 4hrly temperatures + 24hr foetal monitoring
3. PO erythromycin 250mg QDS + intense clinical surveillance for chorioamnionitis
4. Monitor neonate for at least 12hrs after delivery (highest risk of infection during this time)