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Repro II > PROM, chorioamnioitis, uterine rupture > Flashcards

PROM, chorioamnioitis, uterine rupture Flashcards

1
Q

PPROM

A

pre-term (before 37 wks), premature rupture of membrane

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2
Q

how does ruptured membranes change vaginal acidity

A

more alkalodic

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3
Q

mid trimester PROM

A

14-26 wks

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4
Q

risks associated with PROM

A

intrauterine infections
placental abruption
umbilical cord prolapse
pulmonary hypoplsia

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5
Q

PROM 24-32wks

A

Abx and GBS prophylaxis at delivery

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6
Q

32-34 wks

A

abx and GBS prophylaxis

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7
Q

> 34wks

A

GBS prophylaxis begins on admission and continues till delivery

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8
Q

abx for PROM

A

ampicillin IV once, followed by IV every 6 hours
amoxicillin
azythromycin

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9
Q

tocolytics

A

delay delivery for 48 hours

magnesium sulfate

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10
Q

IAI

A

intramniotic infection

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11
Q

chorioaminoitis

A

IAI

infection of amniotic fluid, membranes, plancta, and or decidua

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12
Q

uncommon methods to infection

A

transplacental d/t bacteremia (listeria)
amniocentisis
chorionic villus sampling
fetal surgery

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13
Q

risk factors for chorioamnioitis

A 
prolonged labor
prolonged membrane rupture
multiple digital vaginal exams
nullparity
previous IAI
meconium stained amnion
internal fetal or uterine monitoring
presence of GI tract pathogens
alcohol
tabacco
PROM
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14
Q

clinical presentation of chorioamnioitis

A 
fever
uterine tenderness
maternal tachy
fetal tachy
purulent or foul smelling amniotic fluid
maternal leukocytosis
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15
Q

risks of chorioamnioitis

A

increased risk of labor abnormalities (uterine atony, postpartum hemorrhage, endometritis)
dydfunctional myometrial contractility d/t inflammation
if they have c-section have increased risk for wound infection, endomyometritis, venous thrombosis

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16
Q

Dx chorioamnioitis

A

culture of amiontic fluid gold standard, but takes days

17
Q

risk factors for uterine rupture

A 
previous uterine surger
uterotonic drugs
prolonged and obstructed labor
cephalopelvic disproportion
breech, brow, and face malpresentation 
early pregnancy in young girls
malnutrition
harmful traditional practices (female circumcision)
18
Q

initial care of uterine rupture

A

resusciation with crystalloid fluids, blood products
gastric decompression
urinary catherization
broad spectrum abx

19
Q

laparotomy

A

repair w/or w/o tubal ligation

total abdominal hysterectomy

20
Q

post op care of uterine rupture

A

transfusions, bladder rest, wound care, abx

monitor for obstetrical fistula

Repro II (20 decks)

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