Premature rupture of membranes resident survival guide: Difference between revisions

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==Causes==
==Causes==
Common risk factors in the development of PROM include :
Common risk factors in the development of [[Premature rupture of membranes|PROM]] include :
 
*Maternal risk factors:
*Maternal risk factors:
**[[Sepsis]]
**[[Sepsis]]
**Previous history of PROM, recurrence risk is 16%–32% as compared with 4% in women with a prior uncomplicated term delivery)
**Previous history of [[PROM]], recurrence risk is 16%–32% as compared with 4% in women with a prior uncomplicated term [[delivery]].
**Chronic steroid therapy
**Chronic [[Steroid 21-hydroxylase deficiency|steroid]] [[therapy]]
**Abnormal bleeding during the second trimester or late in the pregnancy,
**[[Abnormal uterine bleeding|Abnormal bleeding]] during the second [[trimester]] or late in the [[pregnancy]].
**Low body mass index (BMI < 19.8 kg/m2)
**Low [[body mass index]] ([[Body mass index|BMI]] < 19.8 kg/m2)
**Smoking and drug abuse
**[[Smoking]] and [[drug abuse]]
**Low socioeconomic status
**Low socioeconomic status
**Deficiency of copper or vitamin C, along with connective tissue disorders such as  Ehlers-Danlos syndrome, systemic lupus erythematosus are also linked to increased risk of PROM.
**Deficiency of [[copper]] or [[vitamin C]], along with [[connective tissue disorders]] such as  [[Ehlers-Danlos syndrome]], [[Systemic lupus erythematosus|Systemic Lupus Erythematosus]] are also linked to increased risk of [[Premature rupture of membranes|PROM]].
**Direct abdominal trauma
**Direct [[abdominal trauma]]
**Preterm labor
**[[Preterm labor and birth|Preterm labor]]
**Anemia
**[[Anemia]]


*Uteroplacental Factors:
*Uteroplacental Factors:
**Uterine anomalies (such as uterine septum)
**[[Uterine]] anomalies (such as [[uterine septum]])
**Placental abruption  
**[[Placental abruption]]
**Advanced cervical dilatation (cervical insufficiency)
**Advanced [[cervical dilation]] ([[cervical]] insufficiency)
**Prior cervical conization
**Prior [[cervical conization]]
**Cervical shortening in the 2nd trimester (< 2.5 cm)
**[[Cervical]] shortening in the 2nd [[trimester]] (< 2.5 cm)
**Uterine overdistention (polyhydramnios, multiple pregnancy)
**[[Uterus|Uterine]] overdistention ([[Polyhydramnios]], [[Multiple pregnancy]])
**Intra-amniotic infection (chorioamnionitis)
**[[Intra-amniotic infection]] ([[Chorioamnionitis]])
**Multiple bimanual vaginal examinations (but not sterile speculum or transvaginal ultrasound examinations)
**Multiple bimanual [[Vagina|vaginal]] examinations (but not [[sterile]] [[speculum]] or [[transvaginal ultrasound]] examinations)


*Fetal factors include :
*[[Fetus|Fetal]] factors include :
**Multiple pregnancy (preterm PROM complicates 7%–10% of twin pregnancies)
**[[Multiple pregnancy]] ( [[Preterm labor and birth|preterm]] [[Premature rupture of membranes|PROM]] complicates 7%–10% of [[twin]] pregnancies)
**Prematurity
**[[Preterm labor and birth|Prematurity]]
**[[Infection]]
**[[Infection]]
**[[Cord prolapse]]
**[[Cord prolapse]]
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==Do's==
==Do's==
* The content in this section is in bullet points.
 
*The content in this section is in bullet points.


==Don'ts==
==Don'ts==
* The content in this section is in bullet points.
 
*The content in this section is in bullet points.


==References==
==References==

Revision as of 17:42, 20 February 2021


Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Rinky Agnes Botleroo, M.B.B.S.

Synonyms and keywords:

Overview

This section provides a short and straight to the point overview of the disease or symptom. The first sentence of the overview must contain the name of the disease.

Causes

Common risk factors in the development of PROM include :

Diagnosis

Shown below is an algorithm summarizing the diagnosis of [[disease name]] according to the [...] guidelines.

 
 
 
History suggestive of PROM<be>(leakage of fluid from the vagina)
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Physical examination findings confirm PROM
•Pooling of fluid
•Positive nitrazine and Ferning tests
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Sterile speculum examination assess dilation and ultrasound if indicated
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
PROM ruled-out
 
 
 
PROM confirmed
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Check gestational age
•Arrange transportation to tertiary care if possible
•Arrange prompt consult with obstetrician
•Fetal non-stress test and ECG to assess well being
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Induce delivery with oxytocin if at-term gestation
 
Plan delivery if any signs of infection, placental insufficiency, fetal distress, or active labor
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
24-31 weeks
•Antibiotics+steroids
•Delivery if lung maturity is satisfactory
 
32-33 weeks
•Antibiotics+steroids
•Delivery at 34 weeks or amniocentesis if abortion is suspected
 
34-36 weeks
•Group B strep prophylaxis
•Delivery

Treatment

Shown below is an algorithm summarizing the treatment of [[disease name]] according the the [...] guidelines.

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

Do's

  • The content in this section is in bullet points.

Don'ts

  • The content in this section is in bullet points.

References

  1. ↑ Naeye RL (1982). "Factors that predispose to premature rupture of the fetal membranes". Obstet Gynecol. 60 (1): 93–8. PMID 7088456.


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