PROMM and chorioamnionitis

Question 1

Complications of PPROM

Answer 1

fetal: prematurity, infection, pulmonary hypoplasia
maternal: chorioamnionitis

Question 2

diagnosis

Answer 2

sterile speculum to check for pooling of amniotic fluid
if pooling of fluid is not observed NICE recommend testing the fluid for placental alpha microglobulin-1 protein or insulin-like growth factor binding protein

Question 3

management

Answer 3

admission
regular observation
oral erythromycin - 10 days
antenatal steroids
delivery should be considered at 34 weeks

Question 4

chorioamnionitis

Answer 4

ascending bacterial infection due to preterm premature rupture of membranes

Question 5

management of chorioamnionitis

Answer 5

IV Abx and prompt delivery of the baby

Question 6

Rupture of membranes (ROM):

Answer 6

The amniotic sac has ruptured.

Question 7

Spontaneous rupture of membranes (SROM)

Answer 7

The amniotic sac has ruptured spontaneously.

Question 8

Prelabour rupture of membranes (PROM)

Answer 8

The amniotic sac has ruptured before the onset of labour.

Question 9

Preterm prelabour rupture of membranes (P‑PROM):

Answer 9

The amniotic sac has ruptured before the onset of labour and before 37 weeks gestation

Question 10

Prolonged rupture of membranes (also PROM):

Answer 10

The amniotic sac ruptures more than 18 hours before delivery.

Question 11

definition of prematurity

Answer 11

< 37 weeks

Question 12

preterm labour with intact membranes

Answer 12

Preterm labour with intact membranes involves regular painful contraction and cervical dilatation, without rupture of the amniotic sac.

Question 13

improving outcomes in preterm labour

Answer 13

CTG monitoring
tocolysis with nifedipine
maternal corticosteroids
IV MgSO4
delayed cord clamping