ROM

Question 1

HPI

Answer 1

"sudden gush of fluids from vagina"
"water running down the legs"
\+
cnx
vag spotting

Question 2

common changes in pregnancy mistaken for ROM

Answer 2

increased vaginal discharge
slight wetness to underwear
urinary incontinence

Question 3

ROM SSE

Answer 3

1. pooling
2. cervical dilation, lesions, bleeding
3. GBS
4. swab for ferning
5. nitrazine test

Question 4

nitrazine test

Answer 4

pH > 6.5 c/w ROM
false pos with:
- blood
- semen
- BV

Question 5

ROM SDE

Answer 5

if >34w and planned delivery, need to check cervix for IOL or labor aug

do NOT perform intracervical digital exam if:

• <34 w if susp ROM
• repeat exams

Question 6

ROM US

Answer 6

• AFI
  (oligo sugg ROM)
• if no PRN, fetal biometry
  (EFW erroneous if oligo)

Question 7

ROM dispo

Answer 7

• admit

- start IOL if >=34 w

Question 8

negative ROM workup dispo

Answer 8

• *d/c if:
• reassuring FHT
• no evidence PTL
• neg ROM workup
• *counsel pt on PTL
• *f/u closely