Flashcards in PROM and chorioamnionitis and postpartum hemorrhage Deck (57)
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1
risks for preterm premature rupture of uterine membranes
previous PROM, preterm labor, vaginal uteral infections, smoking, mechanical stress, GU tract infections, antepartum bleeding
2
tests to see if membranes have ruptured
nitrazine and fern test(amnionitc fluid detection)
3
need to rule out what for pprom
urinary incontinence, vaginal discharge, perspiration
4
when is PPROM
PROM before 37 weeks gestation
5
what is mid trimester PROM
PROM 14-26 weeks gestation
6
women with PPROM have increased risk of what
placental abruption
umbilical cord prolapse
pulmonary hypoplasia
7
Tx PPROM
delivery asap
8
when do we give antibiotics for those with PPROM
24-32 weeks
>32 weeks but <34 weeks
9
what antibiotic is used in PPROM? for what pathogen?
ampicillin IV
group B strep
10
what steroid is given to mom if PPROM
bethamethasone for lung maturity
11
what are tocolytics
delay delivery for 48 hours
Mg sulfate
12
side effects Mg sulfate
HA flushing, fatigue, diplopia, DTRs
respiratory depression and cardiac arrest at toxic levels
13
what antibiotic is given for chlamydia tachomatis
azithromycin
14
if penicillin allergy in mom with PPROM what is given
clinda or genta. or cefazolin and cephalexin
15
mother with difficult labor
temperature rises and foul odor present
tachycardia
Dx? and Tx?
chorioamnionitis
gentamycin, clinda or vanco
16
what is chorioamnionitis
infection of amniotic fluid, membranes, placenta or decidua
17
chorioamnionitis is associated with what complications
early neonatal sepsis and penumonia
18
what is a common cause of transplacental infection
listeria monocytogenes
19
what procedures could increase risk of chorioamnionitis
amniocentesis, chorionic villus sampling, fetal surgery
20
risk factors for chorioamnionitis
prolonged labor, prolonged membrane rupture
multiple digital vaginal examinations
nulliparity
previous IAI
meconium stained amniotic fluid,
internal fetal or uterine monitoring
presence of genital tract pathogens
alcohol
tobacco
PROM
21
clinical presentation of chorioamnionitis
fever
uterine tenderness
maternal tachy
fetal tachy
purulent or foul amniotic fluid
maternal leukocytosis
22
risks with labor if have chorioamnionitis
uterine atony
postpartum hemorrhage
endometritis
23
how can chorioamnionitis affect contractions
dysfunctional myometrial contractility from inflammation
24
risks if C section with chorioamnionitis
wound infection, endomyometritis
venous thrombosis
25
what is ddx for chorioamnionitis
pyelonephritis, influenza, appendicitis, pneumonia
26
most specific documentation for intraamnionic infection
culture of amniotic fluid
27
standard Tx for chorioamnionitis
ampicillin 2 g IV q 6 hours
gentamycin 1.5mg/kg q8hr
28
what to use for Tx in chorioamnionitis when patient has penicillin allergy
vanco
29
causes of uterine rupture related to pregnancy
chorioamnionitis
abruptio placentae
rupture of gravid uterus
30
