12 Questions
What is the primary cause of death associated with PROM?
Infection
What is the function of amniotic fluid?
Protection and temperature regulation
What is the characteristic of amniotic fluid when examined under a microscope?
It has a fern-like structure
What is the term for the rupture of the chorion and amnion one hour or more before the onset of labor?
PROM
What is the name of the test that confirms the presence of amniotic fluid?
Nitrazine test
What is the main purpose of obtaining a smear specimen from the vagina?
To test for beta hemolytic streptococci
What is a possible symptom of infection in PROM?
Maternal fever
Why is the client maintained on bed rest if the fetal head is not yet engaged?
To prevent cord prolapse
What is the purpose of a 6-hour observation period after a skin test?
To check for infection
What is the main cause of uterine inversion?
Excessive pulling of the cord
What is the definition of PPROM?
Premature rupture of membranes
What percentage of patients experience uterine inversion after delivery?
45%
Study Notes
Preterm Rupture of Membranes (PROM)
- Rupture of fetal membranes with loss of amniotic fluid before 37 weeks of pregnancy
- Associated with infection of the membranes (chorioamnionitis)
- Characterized by rupture of the chorion and amnion, one hour or more before the onset of labor
- Risk factors: malpresentation, weak areas in the amnion and chorion, subclinical infection, and incompetent cervix
- Leading cause of death: INFECTION (sepsis, septecimia)
Signs and Symptoms of PROM
- Gushing of amniotic fluid from the vagina, or trickle/leak from the vagina in the absence of contraction
- Maternal fever, fetal tachycardia, and mal-odorous discharge may indicate infection
Diagnosis of PROM
- Ferning test: an amniotic fluid sample is placed on a glass slide, and a fern-like structure is seen under the microscope
- Nitrazine test: the test tape turns blue-green color
Nursing Management of PROM
- Prevent infection and other potential complications
- Minimal vaginal exam
- Obtain smear specimen from vagina to test for beta-hemolytic streptococci
- Determine maternal and fetal status
- Maintain the client on bed rest if the fetal head is not yet engaged to prevent cord prolapse
- Provide client and family education
- Observe for 6 hours, and administer antibiotics if necessary (e.g., cefuroxime, amoxicillin, cephalexin)
PPROM (Preterm Premature Rupture of Membranes)
- Membrane rupture occurs before reaching term
- Increased risk of infection and complications
Uterine Inversion
- Uterus turns completely or partially inside out, occurring immediately after delivery of the placenta or in the immediate postpartum period
- Etiology:
- Forced inversion: caused by excessive pulling of the cord or vigorous manual expression of the placenta or clots from an atonic uterus
- Spontaneous inversion: caused by increased abdominal pressure from bearing down, coughing, or sudden abdominal muscle contraction
Test your knowledge on Preterm Rupture of Membranes, a condition where the fetal membranes rupture before 37 weeks of pregnancy, leading to complications such as infection and malpresentation. Learn about the causes, risks, and consequences of PROM.
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