Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

YEAR 3 REVISION > PROM and PPROM > Flashcards

PROM and PPROM Flashcards

1
Q

What is PROM?

A

Pre-labour Rupture of Membranes (occurs at least 1 hour before the onset of contractions)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the associated risk factors for PROM?

A
  • Ill-fitting PP (e.g. OP)
  • Polyhydramnios
  • Chorioamnionitis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Why is PROM an issue?

A
  • Liquor needed for lung development (acts as surfactant)

- Infection risk if >24 hrs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the management for PROM if risk factors are present?

A
  • CTG

- Obstetric referral for care planning (e.g. ?induction)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the management for PROM if there are no risk factors?

A
  • Intermittent auscultation
  • No speculum needed if clear evidence of ROM
  • No VE unless in active labour
  • Expectant management
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What should happen after 24 hours if labour does not occur spontaneously?

A

IOL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What should women be advised to do to confirm ROM if it is not obvious?

A

Go for a walk with a sanitary pad in and encourage coughing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is GBS?

A

Group B Streptococcus (normal vaginal flora that comes and goes naturally)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How is GBS diagnosed?

A

In urine or private GBS test if requested (routine testing not recommended)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the management for women who are GBS +ve in this pregnancy?

A

IAP and active management

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the management for women who had previous GBS in pregnancy?

A

Active management

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is expectant management of PROM?

A

Wait 24 hours for spontaneous labour - if this doesn’t occur, IOL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is active management of PROM?

A

Give oral misoprostol to encourage contractions (+ augmentation if necessary)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is IAP?

A

Intrapartum Antibiotic Prophylaxis

  • Benzylpenicillin
  • Clindamycin (if allergic to penicillin)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is PPROM?

A

Preterm Pre-labour Rupture of Membranes (<37/40 and before onset of contractions)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the possible complications of PPROM?

A
  • Premature birth
  • Sepsis
  • Cord prolapse
  • Malpresentation
  • APH
17
Q

What are the risk factors for PPROM?

A
  • Infection
  • Polyhydramnios
  • Multiple pregnancy
  • Cervical incompetence
  • Amniocentesis
  • Smoking/drugs
  • Abdominal trauma/DV
18
Q

How is PPROM diagnosed?

A
  • Pool of fluid seen in vagina during speculum examination
  • Nitrazine test
  • USS for oligohydramnios
  • Microscopic examination
19
Q

Who performs a speculum examination?

A 
Term = midwife
Preterm = obstetrician
20
Q

How is the nitrazine test performed?

A
  • Dipped in the fluid to identify if it is liquor

- Inaccurate as can be affected by presence of semen

21
Q

What is the microscopic examination looking for?

A
  • Ferning of crystalline pattern of dried amniotic fluid
  • Presence of lanugo hair
  • Foetal epithelial cells
22
Q

How should PPROM be managed?

A
  • Corticosteroids (as for preterm labour)
  • Anitbiotics
  • Timing of delivery considered
23
Q

What are the RCOG recommendations for timing of delivery?

A
  • Consider from 34/40 onwards

- If expectant management, warn of increased risk of chorioamnionitis but decreased risk of respiratory problems

24
Q

What antibiotics are used for PPROM?

A
  • Erythromycin for 10/7 or until labour

- Penicillin for 10/7 if unable to tolerate/allergic to Erythromycin

25
Q

What is an amnioinfusion?

A

Instilling isotonic liquid into the uterine cavity to improve foetal wellbeing

26
Q

What is the care provided for inpatients with PPROM?

A
  • 4 hourly temp
  • Daily CTG
  • Daily CRP and WCC
  • MSU and LVS/HVS
  • ?discharge after 48 hours
27
Q

What is the care provided for women at home with PPROM?

A
  • Temp QDS (at home)
  • No baths, sexual intercourse or tampons
  • Twice weekly hospital review
  • Fortnightly USS for growth
  • Weekly USS for dopplers
  • Information re. symptoms
28
Q

What are the risk factors for GBS?

A
  • Previous baby with GBS
  • GBS +ve on swab
  • Prematurity
  • PROM
  • Intrapartum infection
  • Pyrexia

YEAR 3 REVISION (49 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions