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Midwifery Emergencies > PPROM > Flashcards

Flashcards in PPROM Deck (16)
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1
Q

What is the definition of PPROM?

A

Premature Prolonged Rupture of Membranes - SROM before 37/40 and before the onset of labour

2
Q

What are some complications of PPROM?

A
  • Prematurity
  • Sepsis
  • Pulmonary hypoplasia
  • Cord prolapse
  • Malpresentation
  • APH
3
Q

What is pulmonary hypoplasia?

A

Low number/size of alveoli in the lungs

4
Q

How is PPROM most commonly diagnosed?

A
  • Pool of fluid seen in vagina during speculum examination

- Make women lie down for 1/2 hour before examination to allow liquid to pool

5
Q

What are some other ways that PPROM is diagnosed?

A
  • Nitrazine test
  • Microscopic examination
  • USS for oligohydramnios
6
Q

Why is the Nitrazine test not reliable?

A

It is a pH test that also indicates vaginal secretions, semen and blood

7
Q

What does the microscopic examination look for?

A
  • Ferning of crystalline pattern of dried amniotic fluid
  • Presence of lanugo hair
  • Foetal epithelial cells
8
Q

What else may these women present with?

A
  • Abdo pain
  • Back pain
  • Bleeding
9
Q

How is PPROM managed?

A
  • Corticosteroids
  • Antibiotics
  • ?Timing and method of delivery
  • Inpatient vs. home care
10
Q

What is the most common antibiotic used and what is given if the woman is unable to tolerate this?

A
  • Erythromycin 250mg QDS for 10 days/ until labour begins

- Unable to tolerate = Penicillin

11
Q

Which antibiotics should not be given and why?

A

Augmentin and Co-Amoxiclav as they increase the risk of NEC

12
Q

How does inpatient management work?

A
  • Temp 4 hourly
  • CTG, CRP and WCC daily
  • USS for liquor, growth and Doppler
  • MSU and HVS/LVS
  • ?Discharge after 48 hours
13
Q

How does home management work?

A
  • Temp QDS (to report if abnormal)
  • Twice weekly review for CTG, CRP, WCC
  • Fortnightly USS for growth
  • Weekly USS for Doppler
  • No baths, sex or tampons
  • Given info regarding signs/symptoms to look for
14
Q

What are the advantages of home management?

A
  • Approx. 10 fewer hospital days as an inpatient
  • Decreased cost
  • Psychological benefit
  • Less danger of infection
15
Q

What are the disadvantages of home management?

A
  • Deterioration may be missed

- Foetal monitoring only twice weekly

16
Q

What is an amnioinfusion?

A

The process of installing isotonic liquid into the uterine cavity