PROM / pPROM

Question 1

Defintion of PROM/pROM

Answer 1

PROM (Premature Rupture of Membranes): It occurs when the amniotic sac (membranes) surrounding the baby breaks before the onset of labor, typically at or after 37 weeks of gestation.

pPROM (Preterm Premature Rupture of Membranes): It refers to the rupture of membranes before 37 weeks of gestation, leading to preterm birth.

Question 2

Causes of PROM/pROM

Answer 2

Infection: Infections of the genital tract, such as urinary tract infections or sexually transmitted infections

Weakened or thin membranes may be more prone to rupture.

Multiple pregnancies

Uterine or cervical abnormalities:

History of PROM

Smoking

Question 3

Symptoms of PROM/pROM

Answer 3

Gush or leakage of fluid from the vagina

Continuous or intermittent fluid leakage

Wetness or dampness in the vaginal area

Sudden decrease or cessation of fetal movement

Pelvic pressure or contractions

Vaginal bleeding (in some cases)

Question 4

Diagnosis of PROM/pROM

Answer 4

Physical examination: Speculum exam to check vaginal fluid pooling,

Nitrazine test to check alkaline pH then fern test.

Ultrasound: An ultrasound may be used to confirm the amount of amniotic fluid, assess fetal growth, and check for any abnormalities.

Question 5

Treatment of PROM/pROM

Answer 5

Expectant management: In cases where the woman and fetus are stable, close monitoring may be recommended to allow time for natural labor to begin.

Antibiotics: If infection is suspected or confirmed, antibiotics may be prescribed to prevent or treat infection.

Corticosteroids: If preterm birth is likely, corticosteroids may be administered to accelerate fetal lung maturity.

Hospitalization: Hospitalization may be necessary for close monitoring, bed rest, and administration of medications.

Induction of labor: If the risks to the mother or baby outweigh the benefits of continuing the pregnancy, labor may be induced.

Cesarean delivery: In certain cases, a cesarean delivery may be performed if there are concerns about the health of the mother or baby.

Preterm PROM
Give steroids and hopefully wait
Rhogam if neccessary,
IV ATBs
Delivery induction if chorioamnionitis
○ Term PROM - rhogam and ATB if necc, deliver. Induce delivery if infection

Question 6

Complications of PROM/pROM

Answer 6

Preterm birth

Infection

Umbilical cord compression

Placental abruption