PROM & PPROM Management PDF

PPROM & PROM Management by Dr. Samar Hassan Mohammed Ali MBBS MD MSc MHPE Assistant professor ob.gyn. AAU PPROM Stands for preterm premature rupture of membranes Means the patient is less than 37 weeks gestation and not in labour and has drainage of liquor. PPROM Ris...

PPROM & PROM Management by Dr. Samar Hassan Mohammed Ali MBBS MD MSc MHPE Assistant professor ob.gyn. AAU PPROM Stands for preterm premature rupture of membranes Means the patient is less than 37 weeks gestation and not in labour and has drainage of liquor. PPROM Risks: Infection : (chorioamnionitis( Developing preterm labour. PPROM Presentation: Passge of water or drainage of liquor. Confirmed by sterile speculum examination. PPROM Management Admition History, General and abdominal examination P.V. Is contraindicated Sterile speculum examination + high vaginal swab for culture and sensitivity Investigations ( CBC ( TWBC) , C reactive protein, ultrasound Antibiotics ( erythromycin) Steroids Meticulous flow up for sign of infection In patient flow up of PPROM patients: Symptoms: Fever, abdominal pain, offensive vaginal discharge Signs: Vital signs ( pulse, temp), abdominal tenderness, fetal heart sound, Investigations: TWBC, C reactive protein. If there is evidence of infection, pregnancy should be terminated. PROM Stands for premature rupture of membranes Means the patient is term, not in labour and has drainage of liquor. Main risk is development of infection ( chorioamnionitis)  PROM Management Admition History and examination Sterile speculum examination + vaginal swab Investigations( CBC, C reactive protein, ultrasound) Antibiotics ( erythromycin) Wait for 24 hours if no evidence of infection. Most cases will go into spontaneous vaginal delivery If she doesn’t go into spontaneous labour, then labour will induced Thank you