With Complete Solutions
Clinically evident intraamniotic infection occurs in ____. Post
partum infection occurs in _____. Incidence of infection is
higher at _______. Correct Answers 15-25%
15-20%
Earlier GA
Consequence of term PROM? Correct Answers Intrauterine
infection, increases with duration of membrane rupture
Definition of PPROM Correct Answers Membrane rupture
before labor and before 37 weeks of gestation
Definition of PROM Correct Answers Rupture of membranes
before the onset of labor
Expected outcome of PROM afer 2nd trimester amniocentesis.
Correct Answers Risk of PROM - 1%. Reaccumulation of
normal AFV should take about 1 month.
How common is preterm deliver in the USA? Correct Answers
12% of all births
How common is PROM? Correct Answers 3%
How common is pulmonary hypoplasia after PROM before 24
weeks? Correct Answers 10-20%. Rarely lethal with PROM
subsequent to 23-24 weeks.
, How long do you wait with adequate contractions before
considering C Section? Correct Answers 12-18 hrs.
How many patients deliver regardless of obstetric managment of
PPROM? How many between 2-5 weeks? Correct Answers
50%, 70-80%
How often does PROM occur prior to viability? Correct
Answers 1%
How often is PROM in term pregnancies? Correct Answers
8%. Generally followed by onset of labor.
How should patient with history of PPROM be managed in
future pregnancy? Correct Answers Hx of PPROM increases
risk for future PPROM. Consider progesterone therapy from
weeks 16 to 24wks to reduce risk of another pre-term birth. If
PPROM was associated with decreased cervical length, consider
cerclage.
How should PPROM with Cerclage be managed? Correct
Answers A firm recommendation on removal cannot be made.
Either retention or removal is reasonable. Regardless of
decision, antibiotics should not be prolonged for any more than
7d
How to diagnose PPROM? Correct Answers History and
Physical Exam for Pooling/Valsalva/Fern, Amnisure, pH test.
US for AFI. If still unclear, US guided transabdominal
instillation of indigo carmine dye.