Module 3
87 Questions
0 Views

Choose a study mode

Play Quiz
Study Flashcards
Spaced Repetition
Chat to Lesson

Podcast

Play an AI-generated podcast conversation about this lesson

Questions and Answers

Which of the following methods can be used to confirm premature rupture of membranes (PROM)?

  • Ultrasound examination
  • Fetal heart rate monitoring
  • Blood pressure measurement
  • Sterile speculum exam (correct)

What is the primary goal of avoiding digital vaginal exams in clients with PROM?

  • To reduce discomfort during examinations
  • To increase the likelihood of natural labor
  • To prevent infection (correct)
  • To assess fetal position accurately

What should be done if no abnormal signs are present during a phone assessment for suspected PROM?

  • Conduct an in-person assessment within 24 hours (correct)
  • Recommend home care without further assessment
  • Advise the client to contact emergency services
  • Wait for 48 hours before reassessing

Which option is available for clients with PROM who initially choose expectant management?

<p>They may revisit their management plan to choose induction of labor (D)</p> Signup and view all the answers

Which sign would indicate the need for an immediate in-person assessment during history-taking for suspected PROM?

<p>Presence of meconium in amniotic fluid (B)</p> Signup and view all the answers

What is a potential complication of PROM that clients should be informed about?

<p>Increased risk of maternal infection (C)</p> Signup and view all the answers

When should management plans for PROM be established after membrane rupture?

<p>Within 24 hours after membrane rupture (B)</p> Signup and view all the answers

Which of the following is NOT a sign that abnormal findings may be present in cases of PROM?

<p>Decelerations in fetal heart rate (B)</p> Signup and view all the answers

What is the primary focus of the TermPROM Study regarding PROM management?

<p>Comparing expectant management and induction of labour (A)</p> Signup and view all the answers

Which of the following outcomes was found to have a decreased risk with planned early birth in the Cochrane review?

<p>Chorioamnionitis (A)</p> Signup and view all the answers

Which management strategy for PROM resulted in a shorter time from rupture of membranes to birth?

<p>Induction within 24 hours (A)</p> Signup and view all the answers

In the context of PROM, which factor is NOT typically associated with its occurrence?

<p>Increased fetal weight (D)</p> Signup and view all the answers

How does the use of epidural analgesia compare with PROM management strategies according to the Cochrane review?

<p>No difference in usage rates (C)</p> Signup and view all the answers

What is a possible complication of expectant management of PROM when done at home?

<p>Increased likelihood of cesarean delivery (D)</p> Signup and view all the answers

Which of the following methods is recommended for antibiotic administration for GBS-positive clients during expectant management?

<p>IAP in the latent phase (D)</p> Signup and view all the answers

Which method is NOT typically used to diagnose PROM?

<p>Ultrasound evaluation (B)</p> Signup and view all the answers

What does the secondary analysis of the TermPROM Study suggest about primiparas managed at home?

<p>They are more likely to receive antibiotics. (B)</p> Signup and view all the answers

What is a purpose of checking the color and odor of amniotic fluid in the management of PROM?

<p>To assess for infection or complications (A)</p> Signup and view all the answers

What factor was not controlled for in the analysis comparing outcomes of expectant management at home or hospital?

<p>Digital vaginal exams (A)</p> Signup and view all the answers

What should a midwife do if they observe contraindications to expectant management during assessment?

<p>Induce labor (B)</p> Signup and view all the answers

How long can the latent period generally extend in clients with PROM before risks significantly increase?

<p>There is no definitive length (D)</p> Signup and view all the answers

In the context of PROM, what particular aspect should be included in daily in-person assessments by midwives?

<p>Monitoring vital signs (C)</p> Signup and view all the answers

What is recommended for clients choosing expectant management at home during the latent period?

<p>Daily in-person assessments (B)</p> Signup and view all the answers

Which group demonstrated no differences in birthing parent or neonatal infection rates according to the studies mentioned?

<p>Home managed primiparas and hospital managed primiparas (B)</p> Signup and view all the answers

What is a common complication associated with PROM?

<p>Higher risk of maternal infection (C)</p> Signup and view all the answers

Which statement is true regarding the monitoring of clients with PROM who choose expectant management?

<p>Monitoring protocols may vary based on studies. (C)</p> Signup and view all the answers

What percentage of individuals with PROM typically give birth within 48 hours?

<p>90% (D)</p> Signup and view all the answers

Which of the following is a key consideration for managing patients expectantly at home?

<p>Ongoing monitoring of vital signs (B)</p> Signup and view all the answers

What factors should a midwife assess regarding the emotional well-being of a client with PROM?

<p>Client's support system (A)</p> Signup and view all the answers

Which statement is true regarding participants with PROM managed in the home setting?

<p>They may have different outcomes based on their circumstances. (C)</p> Signup and view all the answers

Why is it important for clients with PROM to know how to contact their midwife?

<p>In case complications develop (B)</p> Signup and view all the answers

Which of the following is important in interpreting PROM test results?

<p>Client's history of PROM (B)</p> Signup and view all the answers

Which of the following monitoring protocols is part of expectant management in PROM?

<p>Evaluating uterine tenderness daily (A)</p> Signup and view all the answers

What does PROM stand for in the context of childbirth?

<p>Premature Rupture of Membranes (B)</p> Signup and view all the answers

Which factor is associated with an increased risk of infection in both the birthing parent and the newborn when PROM occurs?

<p>Frequent vaginal exams before labor (D)</p> Signup and view all the answers

What is the recommendation for management of a healthy infant born to clients with PROM and who are GBS negative?

<p>Assessment by the midwife based on clinical signs (A)</p> Signup and view all the answers

Which monitoring method is deemed appropriate for clients with PROM when there are no signs of infection?

<p>Intermittent auscultation (A)</p> Signup and view all the answers

What strategy may help clients in making informed decisions regarding management of PROM?

<p>Discussing the differences in infection rates (A)</p> Signup and view all the answers

Clients experiencing PROM at term should be monitored for which potential issue?

<p>Neonatal infection (C)</p> Signup and view all the answers

What is the relationship between the frequency of digital vaginal exams and chorioamnionitis in PROM?

<p>Increased risk of chorioamnionitis (B)</p> Signup and view all the answers

What may be a consequence of expectant management for clients with PROM?

<p>Slightly increased risk of infection (C)</p> Signup and view all the answers

What must clients consider when managing PROM at term?

<p>Both infection risks and benefits of induction (B)</p> Signup and view all the answers

Which of the following is NOT a common method for managing PROM?

<p>Prolonged bed rest (A)</p> Signup and view all the answers

What is a key strategy to encourage safe and effective assisted vaginal birth?

<p>Encouraging skilled care providers for assistance (C)</p> Signup and view all the answers

What is recommended to optimize the fetal head position during labor?

<p>Immediate manual rotation after the onset of labor (C)</p> Signup and view all the answers

What should be included in the debriefing process following an assisted vaginal birth?

<p>Details about the labor and delivery process including indication (B)</p> Signup and view all the answers

In managing a subsequent pregnancy, what should be a primary consideration?

<p>Aiming for spontaneous vaginal birth while respecting patient preferences (D)</p> Signup and view all the answers

Which practice is supported for reducing the necessity of episiotomy during assisted vaginal births?

<p>Restrictive use of mediolateral episiotomy (C)</p> Signup and view all the answers

What is the primary challenge when implementing assisted vaginal birth (AVB) in obstetrical practice?

<p>Inadequate skills and training opportunities (B)</p> Signup and view all the answers

What is recommended for obstetrical trainees in relation to assisted vaginal birth?

<p>To acquire competency in AVB before independent practice (A)</p> Signup and view all the answers

Which approach is correlated with a decreased use of vacuum or forceps in the second stage of labor?

<p>Manual rotation from OT or OP to OA position (C)</p> Signup and view all the answers

What duration of active pushing is considered prolonged for nulliparous women according to contemporary obstetrical practice?

<p>3 hours (C)</p> Signup and view all the answers

What is a significant benefit of extending the duration of active pushing in nulliparous women?

<p>Reduced risk of cesarean delivery (B)</p> Signup and view all the answers

What outcome is likely to be improved by ensuring obstetrical trainees receive appropriate training in assisted vaginal birth?

<p>Enhanced safety and effectiveness of assisted vaginal birth (C)</p> Signup and view all the answers

What should be the approach when managing prolonged second stage labor?

<p>A pragmatic management approach with consideration of the clinical situation (A)</p> Signup and view all the answers

What should midwives prioritize when providing care to clients with diverse gender identities?

<p>Respecting the client's preferred gender pronouns (D)</p> Signup and view all the answers

In the context of assisted vaginal births, what is the primary responsibility of practitioners?

<p>To have the knowledge and skills to manage complications (C)</p> Signup and view all the answers

How should local amendments to clinical guidelines be handled by practitioners?

<p>They need to be well-documented if modified (B)</p> Signup and view all the answers

What is essential for facilitating informed choices for patients in care?

<p>Offering evidence-based, tailored support (A)</p> Signup and view all the answers

Which statement regarding the rights of individuals in care is true?

<p>Patients should actively participate in decision-making (D)</p> Signup and view all the answers

What is a significant factor that midwives should explore with clients regarding their care?

<p>The personal preferences and values of the client (C)</p> Signup and view all the answers

Why should guidelines focus on women at the center of care?

<p>To ensure care is tailored to specific populations (A)</p> Signup and view all the answers

When documenting changes in treatment plans, what is important for midwives to uphold?

<p>Clarity and accuracy in reporting changes (C)</p> Signup and view all the answers

What approach should midwives take to ensure culturally appropriate care?

<p>Tailor care to the individual cultural needs of clients (A)</p> Signup and view all the answers

What role does evidence play in patient care decision-making?

<p>It should inform all care provided to patients (A)</p> Signup and view all the answers

What symptoms should infants be monitored for in relation to medications taken by breastfeeding mothers?

<p>Sedation and poor weight gain (B), Persistent irritability and increased feeding (D)</p> Signup and view all the answers

What is currently NOT recommended for assessing the impact of medications on breastfed infants?

<p>Routine laboratory testing of infant blood levels (A)</p> Signup and view all the answers

Which of the following aspects should a midwife include in monitoring breastfed infants under medication treatment?

<p>Frequency of breastfeeding (A), Changes in routine sleep patterns (B), Timing of medication dosage (C)</p> Signup and view all the answers

What characterizes the relationship between blood levels of medications and adverse effects in breastfed infants?

<p>No correlation between blood levels and adverse effects (C)</p> Signup and view all the answers

In the context of bipolar disorder during postpartum, which consideration is crucial for management?

<p>Monitoring for both mood stabilization and infant safety (D)</p> Signup and view all the answers

What is a potential consequence of persistent maternal postpartum depression on children?

<p>Development of anxiety and disruptive disorders (C)</p> Signup and view all the answers

Which of the following is a common barrier for women with postpartum depression seeking help?

<p>Stigma of mental illness (A)</p> Signup and view all the answers

Which management strategy can positively affect both mothers and their children when dealing with maternal depression?

<p>Remission of postpartum depression (D)</p> Signup and view all the answers

How can maternal postpartum depression impact infant feeding outcomes?

<p>Lower rates of initiating or maintaining breastfeeding (B)</p> Signup and view all the answers

In managing postpartum depression, which factor is most crucial for the well-being of both mother and child?

<p>Timely intervention and treatment for depression (D)</p> Signup and view all the answers

What role can midwives play in supporting women experiencing postpartum depression?

<p>Providing emotional support and encouragement to seek help (C)</p> Signup and view all the answers

Which of the following statements is true regarding the relationship between bipolar disorder and postpartum depression?

<p>Women with bipolar disorder are at higher risk for postpartum depression. (D)</p> Signup and view all the answers

What is the primary benefit of addressing postpartum depression in mothers?

<p>Improved maternal bonding with children (B)</p> Signup and view all the answers

Which of the following is a common barrier to help-seeking for postpartum depression?

<p>Lack of support from family (C)</p> Signup and view all the answers

What is a recommended first-line treatment approach for postpartum depression?

<p>Cognitive Behavioral Therapy (CBT) combined with medication (A)</p> Signup and view all the answers

Which condition is critical for healthcare providers to evaluate in postpartum women to avoid misdiagnosis?

<p>Bipolar disorder (A)</p> Signup and view all the answers

Which strategy may assist midwives in managing postpartum depression effectively?

<p>Offering regular emotional support and follow-ups (D)</p> Signup and view all the answers

What factor can impact the effectiveness of treatment for postpartum depression in mothers?

<p>Socioeconomic status (A)</p> Signup and view all the answers

In which of the following situations should a midwife prioritize referral to a specialist for postpartum patients?

<p>When the patient expresses suicidal thoughts (B)</p> Signup and view all the answers

What psychotropic medication class is commonly prescribed for postpartum depression?

<p>Selective serotonin reuptake inhibitors (SSRIs) (A)</p> Signup and view all the answers

Which symptom is associated with postpartum bipolar disorder that differs from postpartum depression?

<p>High energy and irritability (D)</p> Signup and view all the answers

What is a significant long-term consequence of untreated postpartum depression?

<p>Peer relationship issues in children (C)</p> Signup and view all the answers

Flashcards

Expectant Management for PROM

A method of managing premature rupture of membranes (PROM) where labor is allowed to begin naturally, without inducing labor.

Induction of Labour for PROM

Medical intervention to start labor artificially.

PROM > 37+0 weeks

Premature rupture of membranes occurring at or after 37 weeks and 0 days of gestation.

Digital vaginal exams with PROM

Avoidance of physical examinations of the vagina with PROM to reduce risk of infection.

Signup and view all the flashcards

Initial PROM Assessment

The first methods of checking for PROM, whether via phone or in person.

Signup and view all the flashcards

Abnormal signs (PROM)

Signs such as meconium, bleeding, fever, foul-smelling fluid, or decreased fetal movement during suspected PROM requiring immediate in-person evaluation.

Signup and view all the flashcards

Confirming PROM

Methods like sterile speculum exams, nitrazine test, and fern test to diagnose PROM.

Signup and view all the flashcards

Management Plan (PROM)

A plan created within 24 hours of membrane rupture (PROM) outlining the course of action for managing the PROM.

Signup and view all the flashcards

Intermittent auscultation

Listening to fetal heart sounds periodically instead of continuously.

Signup and view all the flashcards

Prelabour Rupture of Membranes (PROM)

The premature rupture of the amniotic sac before the onset of labour.

Signup and view all the flashcards

Chorioamnionitis

Inflammation of the chorion and amnion, membranes surrounding the fetus.

Signup and view all the flashcards

Expectant management

A method of managing PROM where labor is allowed to begin naturally.

Signup and view all the flashcards

Induction of labor

Actively starting labor with medical interventions.

Signup and view all the flashcards

Meconium staining

Presence of meconium (fetal stool) in amniotic fluid.

Signup and view all the flashcards

GBS Negative

Group B Streptococcus (GBS) bacteria not detected in the birthing parent.

Signup and view all the flashcards

Fetal monitoring

Regularly tracking the health of the fetus during labor.

Signup and view all the flashcards

Neonatal infection

Infection in a newborn.

Signup and view all the flashcards

Informed choice

Decision making about the best approach for the birthing parent, based on values and preferences.

Signup and view all the flashcards

Prophylactic Antibiotics for PROM

Giving antibiotics to individuals with PROM to prevent infection, especially in those with GBS-positive status.

Signup and view all the flashcards

IAP for PROM

Intrapartum antibiotic prophylaxis, given to individuals with PROM during labor to reduce the risk of infection.

Signup and view all the flashcards

Expectant Management: Home vs. Hospital

Comparing the outcomes of managing PROM at home versus in the hospital.

Signup and view all the flashcards

Home Management Risk Factors

Individuals managed at home are at a slightly higher risk of neonatal infection, especially primiparas.

Signup and view all the flashcards

Digital Vaginal Exams and Risk

Digital vaginal exams are a potential risk factor for infection in individuals with PROM.

Signup and view all the flashcards

In-Person Assessments for Home Management

Daily in-person assessments for individuals with PROM managed at home are essential.

Signup and view all the flashcards

Latent Period of PROM

The time between PROM and the onset of active labor.

Signup and view all the flashcards

Timing of Induction for PROM

Determining when induction of labor might be necessary for PROM.

Signup and view all the flashcards

Latent Period Length and Risk

There is no definitive length of the latent period at which the risk of PROM significantly increases.

Signup and view all the flashcards

Sterile Speculum Exam

A vaginal exam using a sterile speculum to visually inspect the cervix for signs of ruptured membranes. It helps confirm or rule out premature rupture of membranes (PROM).

Signup and view all the flashcards

Nitrazine Test

A test that uses pH-sensitive paper to determine if amniotic fluid is present. Amniotic fluid is slightly alkaline, turning the paper blue.

Signup and view all the flashcards

Fern Test

A microscopic test used to identify amniotic fluid by its characteristic fern-like pattern when dried on a slide.

Signup and view all the flashcards

When PROM results are uncertain?

When there's doubt about PROM, multiple tests and the midwife's clinical judgment are crucial to get a clear picture. Ultrasound of amniotic fluid volume may be helpful.

Signup and view all the flashcards

Expectant Management (PROM)

A strategy for managing premature rupture of membranes where labor is allowed to start naturally, without medical intervention.

Signup and view all the flashcards

Monitoring during Expectant PROM Management

Regular monitoring of the birthing parent and fetus is vital during expectant management of PROM, including vital signs, amniotic fluid checks, fetal heart rate, and uterine activity.

Signup and view all the flashcards

Daily Assessment by Midwife for Expectant PROM

The midwife conducts daily in-person assessments during expectant management of PROM, checking vital signs, amniotic fluid, and overall well-being, and reviewing emotional concerns.

Signup and view all the flashcards

Induction of Labour (PROM)

The medical intervention to start labor artificially in cases of PROM, usually considered when complications arise, contraindications are present, or when the birthing parent prefers it.

Signup and view all the flashcards

GBS and PROM

Group B Streptococcus (GBS) bacteria, if present, can pose risks for the baby during PROM. Research on ideal timing for intrapartum antibiotic prophylaxis and labour induction for GBS-positive mothers with PROM is ongoing.

Signup and view all the flashcards

TermPROM Study

A large study investigating the effectiveness of expectant management versus induction of labor for women with PROM at term.

Signup and view all the flashcards

Cochrane Review

A systematic review of medical research that evaluates the evidence on a specific topic. This review compared outcomes of expectant management and induction of labor for PROM.

Signup and view all the flashcards

Prolonged Second Stage of Labor

Labor lasting longer than 3 hours for first-time mothers and 2 hours for those who've had babies before.

Signup and view all the flashcards

Assisted Vaginal Birth (AVB)

Using tools like forceps or vacuum to help deliver a baby vaginally.

Signup and view all the flashcards

Manual Rotation

Moving the baby's position inside the womb by hand to have a better chance of vaginal delivery.

Signup and view all the flashcards

Optimal Position for Delivery

The best position for the baby to be in for vaginal delivery.

Signup and view all the flashcards

Primary Cesarean Delivery

The first instance of a Cesarean section.

Signup and view all the flashcards

Safe and Effective Assisted Vaginal Birth

Using instruments to deliver a baby vaginally, only when it's safe and done by skilled providers.

Signup and view all the flashcards

Obstetrical Trainees and AVB

Obstetrics students should receive proper training and be confident in performing assisted vaginal birth (AVB).

Signup and view all the flashcards

Cesarean Section (CS)

Surgical delivery of a baby through an incision in the abdomen.

Signup and view all the flashcards

Episiotomy

A cut made in the perineum (area between the vagina and anus) to widen the vaginal opening during childbirth.

Signup and view all the flashcards

Debriefing after AVB

A conversation with the patient following an assisted vaginal birth, discussing the procedure, complications, and future implications.

Signup and view all the flashcards

Spontaneous Vaginal Birth (SVB)

A natural childbirth where the baby is born without medical assistance.

Signup and view all the flashcards

Assisted Vaginal Birth

Delivery of a baby through the vagina with the help of instruments like forceps or vacuum extraction.

Signup and view all the flashcards

Knowledge, Skills, and Experience

Practitioners performing assisted vaginal birth must possess these three elements to ensure safe and effective delivery.

Signup and view all the flashcards

Managing Complications

Handling any issues or risks that may arise during an assisted vaginal birth.

Signup and view all the flashcards

Gender Identity and Pronouns

Respecting and using the appropriate gender identity and pronouns of all individuals, including transgender, gender non-binary, and intersex.

Signup and view all the flashcards

Evidence-Based Guidelines

Recommendations for safe and effective practices in healthcare, supported by scientific research.

Signup and view all the flashcards

Local Institutions

Organizations and healthcare providers in a specific location.

Signup and view all the flashcards

Respecting Patient Values

Considering the individual beliefs, needs, and preferences of each patient when providing healthcare.

Signup and view all the flashcards

Informed Consent

The process of obtaining a patient's voluntary agreement for a medical procedure after providing clear information and answering questions.

Signup and view all the flashcards

Clinical Situation Assessment

The evaluation of a patient's health status and needs before and during an assisted vaginal birth.

Signup and view all the flashcards

Postpartum Depression: Impact on Children

Postpartum depression in mothers can lead to disruptions in mother-child interactions, lower cognitive function, and behavioral problems in children.

Signup and view all the flashcards

Persistence of Postpartum Depression

If postpartum depression continues, it increases the risk of children developing anxiety, disruptive behavior, and depression.

Signup and view all the flashcards

Postpartum Depression: Remission

When depression is resolved, it has positive benefits for both the mother and the child.

Signup and view all the flashcards

Postpartum Depression: Breastfeeding

Maternal depression can increase the risk of problems with breastfeeding, like not starting or continuing.

Signup and view all the flashcards

Barriers to Postpartum Depression Care

Stigma and guilt related to mental health can prevent women from seeking help for postpartum depression.

Signup and view all the flashcards

Postpartum Depression: Key Takeaway

Despite being common, postpartum depression often goes untreated due to stigma and other barriers.

Signup and view all the flashcards

Postpartum Depression: Key Words

Important terms related to postpartum depression include antidepressants, bipolar disorder, lactation, psychotherapy, and screening.

Signup and view all the flashcards

Postpartum Depression

A mood disorder that can occur after childbirth, characterized by feelings of sadness, anxiety, and hopelessness.

Signup and view all the flashcards

Puerperal Psychosis

A serious mental illness that can occur after childbirth, characterized by hallucinations, delusions, and rapid mood swings.

Signup and view all the flashcards

Postpartum Psychosis

A severe mental illness that can occur after childbirth, characterized by hallucinations, delusions, and disorganized thinking.

Signup and view all the flashcards

Perinatal Depression

A type of depression that can occur during pregnancy or within the first year after childbirth, involving sadness, anxiety, and loss of interest in activities.

Signup and view all the flashcards

Maternal Infanticide

The killing of an infant by its mother, often motivated by postpartum psychosis or severe depression.

Signup and view all the flashcards

Sleep Loss and Postpartum Psychosis

Lack of sleep is a significant risk factor for developing postpartum psychosis.

Signup and view all the flashcards

Missed Bipolarity and Postpartum Depression

Women with postpartum depression may have undiagnosed bipolar disorder, which can complicate their recovery.

Signup and view all the flashcards

Postpartum Thyroid Dysfunction

Hormonal changes after childbirth can lead to thyroid problems, which sometimes contribute to postpartum mood disorders.

Signup and view all the flashcards

Ferritin Levels and Postpartum Depression

Low iron levels (ferritin) after delivery are associated with a higher risk of postpartum depression.

Signup and view all the flashcards

Canadian Network for Mood and Anxiety Treatments (CANMAT)

This organization provides clinical guidelines for managing major depressive disorder, including postpartum depression.

Signup and view all the flashcards

Postpartum Depression: What We Know

Research continues to understand the causes, symptoms, and effective treatment options for postpartum depression.

Signup and view all the flashcards

Remissions in Maternal Depression and Child Psychopathology

Treating maternal depression can improve both the mother's mental health and reduce the likelihood of behavioral problems in children.

Signup and view all the flashcards

Study Notes

Prelabour Rupture of Membranes at Term (PROM)

  • PROM is a common pregnancy complication, occurring in approximately 10% of pregnancies, with 60-80% occurring at term.
  • PROM is associated with increased morbidity for the birthing parent and neonate.
  • Factors associated with PROM include a history of PROM, cigarette smoking, and simultaneous Vitamin C and E supplementation.

Incidence of PROM

  • PROM occurs in approximately 10% of all pregnancies.
  • PROM incidence ranges from 2.7% to 17% and is highest around term.

Complications with PROM

  • Complications include: chorioamnionitis (1-4%), endometritis (up to 3.2% after vaginal delivery), and cord prolapse (0.002%).
  • Early-onset neonatal sepsis rates are very low (0.0002%).

PROM Management: Early Induction of Labour vs. Expectant Management

  • The TermPROM Study investigated expectant management versus early induction.
  • Results showed both expectant management and early induction to be reasonable options.
  • An updated Cochrane review (2017) of individuals at ≥37 weeks analyzed planned early birth and expectant management.

Diagnosis of PROM

  • Three main methods confirm PROM: sterile speculum exam, nitrazine test, and fern test.
  • Multiple methods are recommended for uncertain results.
  • Ultrasound evaluation of amniotic fluid volume is also considered helpful in uncertain situations.

Practical Aspects of PROM Management

  • No single ideal monitoring protocol for the birthing parent and fetus during expectant management was identified.
  • Expectant management strategies commonly include checking temperature frequently, checking amniotic fluid color and odor, monitoring fetal heart rate, and conducting daily non-stress tests.
  • Implementing daily in-person assessments in clients' homes, clinics, or hospitals is considered appropriate.

PROM and GBS (Group B Streptococcus)

  • Evidence shows a non-significant trend suggesting that GBS-positive patients with PROM induced with oxytocin had a lower risk of early-onset group B streptococcal disease.
  • Risk of EOGBSD increases with the duration of ROM.

Expectant Management of PROM (Home or Hospital)

  • Very limited research directly compares expectant management at home versus hospital.
  • Secondary analysis of TermPROM Study suggests similar outcomes for home and hospital management, but limitations exist.
  • Factors like digital vaginal exams and other potential risk indicators weren't completely controlled.

Timing of Induction for PROM

  • No definitive latent period exists where PROM risks significantly increase.
  • Approximately 75% of PROM cases result in birth within 24 hours, 90% within 48 hours, and 95% within 72 hours.
  • Risk of maternal and neonatal infection increases with longer latent periods.

Intrapartum Management

  • No evidence suggests that warm baths during labour increase the risk of postpartum infection.
  • Intermittent auscultation is an acceptable fetal monitoring method in the absence of fetal compromise.

Postpartum Management

  • Monitoring for neonatal infection is essential in clients with PROM.
  • The birthing parent's health assessment should follow standard clinical protocols.

Conclusion

  • Although PROM is a common pregnancy event, the optimal management remains debated.
  • Clients must weigh the slightly increased infection risk with expectant management against the risks associated with induction.
  • Providing clients with thorough information enables informed decision-making regarding PROM management in line with individual values.

Studying That Suits You

Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

Quiz Team

Related Documents

AOM Clinical Practice Guideline Summary: Management of PROM at Term (PDF)
SOGC Clinical Practice Guideline No. 381 Assisted Vaginal Birth 2019 PDF
Postpartum Depression: Diagnostic and Treatment Issues PDF

Description

Explore the complexities of Prelabour Rupture of Membranes (PROM) at term, a common complication in pregnancy. This quiz covers its incidence, complications, and management strategies, providing essential insights for healthcare professionals. Test your knowledge on the various factors affecting PROM and its implications for both birthing parents and neonates.

More Like This

Use Quizgecko on...
Browser
Open
Browser
Browser