RANZCOG term PROM Flashcards
what is the incidence of pre labour ROM >37/40?
- 8% or 1:12
What percentage of women with term PROM will start contracting within 24, 48 hours and 96 hours respectively?
70%
85%
95%
what are the immediate risks of ROM?
- cord prolapse
- cord compression
- placental abruption
what are the long term risks of ROM at term?
- neonatal and maternal infection
- neonatal infection can result in death, chronic lung disease and cerebral palsu
what are the criteria for expectant management that a woman should meet for this to be acceptable?
- fixed cephalic presentation
- no GBS risk factors
- no signs of maternal infection
- clear liquor
- normal CTG and good FM
- access to reliable transport
- commitment to monitoring temperature, fetal movements
- documented consversation
What is the risk of maternal chorioamnionitis when term PROM is managed actively vs expectantly?
RR of 0.49 (54/1000 vs 110/1000)
What is the risk of early onset neonatal sepsis when term PROM is managed actively vs expectantly?
RR 0.73 (30/1000 vs 41/1000)
What is the risk of CS when term PROM is actively managed vs expectantly managed?
RR 0.84 (126/1000 vs 150/1000)
what is the risk of neonates receiving antibiotics amongst term PROM actively vs expectantly managed?
RR 0.61 (85/1000 vs 126/1000)
what is the risk of neonatal admission in women who are actively managed for PROM vs expectantly managed?
RR of 0.75 (129/1000 vs 160/1000)
What is the role of antibiotics prior to labour for women with term PROM?
- if -ve GBS risk factors then no benefit prior to labour
- if GBS status is unknown then treat as per GBS guideline
- if chorioamnionitis suspected then IV antibiotics + expedite labour
Should IOL be undertaken with oxytocinon or prostaglandins?
- Oxytocinon is first line
- if cervix unfavourable prostaglandin acceptable
