preterm labour

Question 1

what does PPROM stand for

Answer 1

preterm pre labour rupture of membranes

Question 2

what is PPROM ?

Answer 2

a gush of amniotic fluid due to ROM not directly preceding labour at less than 37 weeks

Question 3

Prolonged rupture of membranes (also PROM)

Answer 3

:The amniotic sac ruptures more than 18 hours before delivery.

Question 4

what is the prophylaxis of pre term labour

Answer 4

Vaginal Progesterone
Cervical Cerclage- adding a stitch into cervix keeping it closed

Question 5

how is PPROM diagnosed

Answer 5

• by sepculum- showing fluid pooled in post fornix
• nitrazine test ( >ph 7.1)
• positive fern test ( 1D cervical mucus)
• IGF-1 test/ Placental alpha microglobulin-1 (PAMG-1)- present in high concentrations of amniotic fluid

Question 6

what is the tx for PPROM

Answer 6

10d PO erthyromycin 250mg ( prevent chorioamnionitis
QDS + antenatal steroids ( fetal lining mat)

Question 7

how is Preterm Labour with Intact Membranes dx

Answer 7

• if <30 weeks- clinical assessment- offer management
• if >30 weeks- a TVUSS to assess cervical length if <15 offer management

Question 8

how is preterm labour managed

Answer 8

• Fetal monitoring (CTG or intermittent auscultation)
• Tocolysis with nifedipine
• Maternal corticosteroids
• IV magnesium sulphate
• Delayed cord clamping or cord milkin