PPROM

Question 1

Tatalaksana PPROM

Answer 1

Apabila ada danger sign, dilakukan terminasi. Apabila tidak, tatalaksana disesuaikan oleh usia gestasi

Question 2

Danger sign pada PPROM -> terminasi, apa aja? (5)

Answer 2

Choriamnionitis
Abruptio placenta
Nonreassuring fetal testing
Memasuki persalinan
Fetal death

Question 3

usia gestasi periviable

Answer 3

di bawah 23-24 minggu

Question 4

tatalaksana UK periviabel

Answer 4

Konseling
Antibiotik
Induksi labor atau expectant management

Question 5

Usia gestasi preterm

Answer 5

24-33 minggu

(24 0/7 - 33 6/7)

Question 6

Tatalaksana pada UK preterm (5)

Answer 6

Expectant management
Antibiotik
kortikosteroid
GBS profilaksis
MgSO4 pada usia gestasi di bawah 32 minggu
tokolitik?

Question 7

Usia gestasi late preterm

Answer 7

34 -36 minggu
34 0/7 - 36 6/7

Question 8

Tatalaksana UK late preterm

Answer 8

Expectant management atau terminasi
Kortikosteroid
GBS prophylaxis
Tokolitik

Question 9

UK term

Answer 9

37 minggu keatas

Question 10

tatalaksana UK term

Answer 10

Terminasi
GBS profilaksis

Question 11

Komplikasi PPROM maternal

Answer 11

Chorioamnionitis
Abruotio placenta
Endometritis
Prolaps cord
Oligohidramnion

Question 12

Komplikasi PPROM fetal

Answer 12

Fetal distress
Respiratory distress sydrome
Necrotizing enterocolitis
Hipoplasia pulmoner

Question 13

Pemeriksaan fisik dan penunjang

Answer 13

Bimanual dihindari
Spekulum : cairan di fornix posterior
Nitrazine test (pos kalo >6 pHnya, jadi biru)
Ferning test ( pos kalo bentuk pakis di mikroskop)
USG (cek indeks cairan amnion)

Question 14

Faktor risiko maternal

Answer 14

PPROM sebelumnya
Pendarahan antepartum
PPI
Anemia
BMI rendah

Question 15

Faktor risiko uteroplacenta

Answer 15

Cervical insufficiency
Chorioamnionitis
Overdistensi uterus

Question 16

Faktor risiko fetal

Answer 16

Gemelli
Anomali fetus

Question 17

Pemberian kortikosteroid

Answer 17

Dexamethasone (4x/24 jam, 1 seri)
Betamethasone (2x/24 jam, 1 seri)

Question 18

Pemberian antibiotik

Answer 18

per IV : ampicillin, erythromycin +
per oral : amoxicillin, erythromycin

Question 19

GBS profilaksis

Answer 19

Beta lactam: penicillin atau ampicillin per IV
saat persalinan

Question 20

Patofisiologi PPROM

Answer 20

infeksi*/polihidramnion/amniocentesis/smoking/idiopatik -> aktivasi kaskade inflamatori -> degradasi protein amnion -> ruptur amnion -> amnion rembes lewat serviks

Question 21

infeksi yang sering menyebabkan PPROM

Answer 21

bacterial vaginosis, genital tract infection, ISK

Question 22

ciri chorioanionitis

Answer 22

….

Question 23

ciri abruptio plasenta

Answer 23

…