PPROM Flashcards
(18 cards)
define PPROM
premature pre labour rupture of membrane is the leakage of amniotic fluid through the cervix before 37 weeks gestation
differential dx for PPROM
- PV discharge
- involuntary passage of urine
6 causes of PPROM
- infection
- incompetent cervix
- polyhydramnios and multiples = overdistended uterus
- IOL
- complication of amniocentesis
- complication of external cephalic version
steps to diagnosing PPROM
- History
- leaking fluid
- risk factors - Exam
- infection signs
- abdominal
- sterile speculum
- NO PV - Side room
- litmus
- amniosure
- micro
what would happen in the litmus test
turns blue
what would be seen on micro
ferning
how is PPROM managed?
- Admit
- bedrest
- sterile pads
- avoid VE
- Steroids
- USS
- assess for infection
what will be seen on speculum ?
fluid pooling in posterior fornix
why is USS done?
assess fetal growth and re-accumualtion of fluid
What is the purpose of giving steroids?
enhancement of fetal lung maturity
BMZ 12mg x2 doses 24 hrs apart
How does one assess for maternal and intra-uterine infection?
- CTGs ( fetal tachycardia )
- maternal pulse and temp
- assessment of liquor smell and colour
- uterine tenderness
- twice weekly WCC/CRP
which antibiotic should be given in the case of infection?
Azithromycin
outcomes of PPROM
- membranes re-seal and liquor re-accumulates – discharge and counsel
- development of intrauterine infection or fetal distress – deliver
- 34 weeks+ – IOL
how will you know that membranes have resealed?
on USS and pads checks are dry
name 5 complications of PPROM
- Chorioamnionitis
- Oligohydramnios
- Neonatal death
- Chord prolapse
- Placental abruption
why is oligohydramnios a risk
pulmonary hypoplasia before 24 weeks
causes of neonatal death in a case of PPROM
- prematurity
- sepsis
- lung hypoplasia
