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Premature rupture of membranes (PROM) - Coggle Diagram
Premature rupture of membranes (PROM)
Def.
Spontenous rupture of membrane any time beyond (after) 22 wks (and before onset of labour) * 10% of all pregnancies
Types
1- Term
:question: rupture of membrane beyond ( after ) 37 wk ((8% of all pregnancies ))
2- Preterm
:question: rupture of membrane before 37 completed weeks ((2-3% of all pregnancies ))
Etiology
Not known
:arrow_up: friability of membranes
:arrow_down: tensile strength membranes
Poly hydramnios
Cervical incompetence
Multiple pregnancies
Infections
Cervical length <2.5 cm
Perior preterm labour
Low BMI <19 kg/m2
Diagnosis
History
(discharge of clear liquid) Liquor
Examination
liquor drainage
Differential diagnoses
Incompetence of urine
PROM
Investigations
Collected fluid
A. Ferent test
(crystallization of liquor)
B. Amniosure test
Risks
Maternal
Preterm labor
:arrow_up: risk of infection
Fetal
Cord prolapse
Intrauterine infection
Fetal pulmonary hypoplasia
Neonatal sepsis
Respiratory distriss syndrome
Intraventricular hemorrhage
Necrotizing enterocolitis (NEC)
Management
depends on:
In Labor or not :question:
Sepsis (Any evidence):!?:
Prospect of fetal survival in the :hospital:
Gastation age of fetus (according doctor sometimes they will delay delivery, unless severe anomalies)
If
amnionitos, placental abruption, fetal death / distriss
Labor process
Effective delivery + broad spectrum intrapartum antibiotics + admit baby to NICU
If
GA <34 wks
: (aim to continue fetal maturity) so transverse to :hospital: equipped with NICU
If
GA >34 wks
: ((wait for spontaneous labor for 24-48hr)) if failed
->
induction of labor with oxytocin or C/S