PROM

Question 1

Spontaneous rupture of the membranes prior to the onset of labor

PPROM - before 37 weeks gestation

Answer 1

Premature rupture of membranes (PROM)

Question 2

Risk Factors

Answer 2

Infection (Cervicitis)
Previous history of PROM
Hydramnios
Multiple Pregnancy
UTI

Question 3

Maternal Implications:

Answer 3

Infections: Chorioamnionitis and Endometritis

Abruptio placenta occurs more frequently in women with PROM

Question 4

Fetal newborn implications:

Answer 4

•risk for respiratory distress syndrome (with PROM)

•fetal sepsis

•malpresentation

•prolapse of the umbilical cord

• Increased perinatal morbidity and mortality

•fetal anomalies

Question 5

Assessment:

Answer 5

~Determine the duration of rupture of the membranes and gestational age

~ observe the mother for signs and symptoms of infection:
- WBC Count
- Temperature
- PR
- Character of amniotic fluid

~ Sterile vaginal speculum exam:
- Nitrazine test
- Fern test

Question 6

Assessment part 2

Answer 6

~ Sonogram
~ Blood test: C reactive protein
~ Urinalysis
~ No digital exam

Question 7

Planning: The woman’s risk for infection will decrease by identifying the sign and symptoms of infection thru:

Answer 7

1.) Knowing how to read a thermometer and to know to what to degree of temperature she should report

2.) Refraining from tub bathing, douching and coitus

3.) Identify odorous vaginal discharge

Question 8

Management:

Answer 8

~ Rest on left side
~ Increase temperature = maintain hydration
~ Take VS and FHR q4h
~ WOF temp greater than 38 degrees Celsius
~ Note vaginal discharge
~ Note uterine contractions