PROM and chorioamnionitis and postpartum hemorrhage Flashcards Preview

Year2 Repro exam II > PROM and chorioamnionitis and postpartum hemorrhage > Flashcards

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

causes of uterine rupture uncrelated to pregnancy

torsion ovarian cyst or rupture
strangulated hernia, intestinal obstruction
renal colic, acute appendicitis