PROM, PTL,& IUGR Flashcards
What is amniorrhexis?
Spontaneous rupture of membranes
What is amniotomy?
Artificial or intentional rupture of membranes
What is PROM or preterm rupture of membranes?
Spontaneous rupture of membranes before the onset of labor & past 37 weeks
What is PPROM or premature preterm rupture of membranes?
Spontaneous rupture of membranes before the onset of labor & before 37 weeks gestation
abnormal membrane physiology; cervical insufficiency; vaginal infection that ascends; nutritional deficiency can all be causes for what?
PROM or PPROM
If a patient experiences PROM and has amniotic infection, bad fetal HR tracing, cord prolapse, or active labor what is the appropriate management?
Deliver the fetus
What are the three test used to diagnose PROM?
Nitrazine paper test, Fern test, and Amnisure test
What is a positive dx of PROM in the Nitrazine test?
paper will turn blue from amniotic fluid
What is a positive diagnostic result of PROM in a fern test?
When sample is airdried it will “fern” on the slide
This test for PROM is highly accurate & measures the placental alpha microglobulin-1 (PAMG-1)?
Amnisure
If a patient is diagnosed with PPROM and is 34-36 weeks, what is the proper treatment?
Give GBS ABX and deliver baby
If a patient is diagnosed with PPROM and is 32-33 weeks, what is the proper treatment?
- Give corticosteroids
- Give ABX
- Deliver at 34 weeks
What is a sudden leaking or gushing of fluid and fluid seen leaving the cervical os on pelvic exam?
PROM
What are the parameters for preterm labor (PTL)?
> 20 weeks but <37 weeks
This is defined as deliveries occurring from 20 weeks up to 37 weeks of gestational age?
Preterm delivery or preterm birth (same thing)
These are risks to the fetus following what: Pulmonary hypoplasia, asthma, underdeveloped organs, lo birth weight, & feeding issues?
preterm delivery
What is the lower limit of viability in a fetus born preterm (Weeks or weight in grams)?
24 weeks or 500 g
Abnormal placenta, vaginal infections that ascend, diabetes; HTN; UTI; smoking; vitamin D deficiency, and thrombophilia’s are all risk factors for what occurring?
Preterm labor
What are the 4 causes of preterm delivery?
Infection in mother
abnormal placental invasion
Psychological and physical stress
Uterine stretch
This cause of preterm birth is from BV or cystitis and results in shortening of the cervix?
genital ascending infection
This cause of preterm birth is due to poor trophoblasts invasion of the spiral arteries in the myometrium resulting in a poor vascular connection between placenta and mom?
Placental abnormalities (or abnormal placenta)
What protein helps keep the uterus relaxed so it doesn’t sense stretch and expel the fetus?
parathyroid-related protein
What can cause uterine stretch suppression malfunction and lead to preterm delivery?
- polyhydramnios, or too much amniotic fluid
- multiple gestations
- macrosomia, fat baby
What is polyhydramnios
too much amniotic fluid
What is macrosomia?
fetus that’s way too big; >4500g or 8Ib 13oz
What is the warning sign patients should notice in PROM?
sudden gush or fluid or constant leakage from vagina
Fluid leaking from your vagina, vaginal bleeding or pink discharge, N/V, contractions, back pain and pelvic pain are all warning sigs of what?
Preterm labor
What two elements are required to diagnose preterm labor?
Documented uterine contractions & documented cervical change
When assessing for preterm labor, what level of contractions are considered positive for the dx?
4 per 20 minutes or 8 per 60 minutes
When assessing for preterm labor, what level of cervical change is considered a positive dx?
cervical effacement of 80% or cervical dilation of 2 cm or more
If a patient is presenting in preterm labor but their membranes aren’t ruptured, what is the appropriate treatment?
Put pt in lateral decubitus
give IV fluid, GBS test, and magnesium sulfate to slow labor
Definition of low birth weight?
less than 5 pounds, 8 ounces
can be perfectly healthy
Definition of intrauterine growth restriction?
poor fetal growth during pregnancy and reduced size at birth due to pathological cause; fetus is <10th percentile
What is fetal death between 20 weeks’ gestation and the onset of labor
intrauterine fetal demise
What are the two classifications of IUGR?
Symmetrical - all parts of body are small
Asymmetrical - head and brain NL, rest of body is too small
This fetal growth abnormality is caused by abnormal placental growth, thrombophilia’s, and infections like CMV or toxoplasmosis?
Intrauterine growth restriction
If a fetus is suspected to be suffering from IUGR, how oftern is US indicatied?
