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Spontaneous Rupture of Membranes

Fetal Membrane Rupture


Presentation

  • The physiological reasons for this rhythm are not understood at the present time.[ncbi.nlm.nih.gov]
  • We conclude that there is no advantage to delaying induction of labor when women present at term with spontaneous rupture of membranes.[ncbi.nlm.nih.gov]
  • Spontaneous membrane rupture has been associated with an incompetent cervix - producing 'forewater' rupture - multiple births, foetal distress, chorioamnionitis, and breech presentation. Links: management[gpnotebook.com]
  • […] infection may already be present or may develop - both clinical signs and laboratory tests should be monitored antibiotic treatment is effective in prolonging pregnancy and in reducing both maternal and neonatal morbidity but will not reduce neonatal[aippg.net]
  • , delivery of the presenting fetus at 18.4 weeks, and delivery of an infant at 29.9 weeks with no chronic complications.[nature.com]
Febrile Convulsions
  • Clinical paediatric pathways Abdominal Pain Acute asthma/wheeze Bronchiolitis Diarrhoea and vomiting Fever Head Injury Sepsis Safety netting documents for parents Abdominal Pain Asthma Action Plan Asthma - Acute Exacerbation Bronchiolitis Febrile Convulsion[what0-18.nhs.uk]

Treatment

  • Treatment for premature rupture of membranes: Specific treatment for PROM will be determined by your physician based on: your pregnancy, overall health and medical history extent of the condition your tolerance for specific medications, procedures or[chw.org]
  • Quintero RA: Treatment of previable premature ruptured membranes. Clin Perinatol 2003;30:573–589.[karger.com]
  • […] indicated in the presence of malpresentation or fetal distress but confers no benefit in an otherwise uncomplicated vertex presentation infection may already be present or may develop - both clinical signs and laboratory tests should be monitored antibiotic treatment[aippg.net]
  • The efficacy of corticosteroid use at 32–33 completed weeks is unclear based on available evidence, but treatment may be beneficial particularly if pulmonary immaturity is documented.[sharinginhealth.ca]
  • Treatment for Rupture of Membranes There is no treatment for rupture of membranes. For some women, this process can begin around the week 38 or 39. For others, your baby may wait until week 41 or 42.[babymed.com]

Prognosis

  • In pregnancies in which ROM occurred before 20 weeks, the prognosis was poor. In this group, later age at delivery did not confer a survival advantage.[nature.com]
  • . · Antibiotics (up till delivery) Prognosis Prognosis to fetus and newborn depends on: · gestational age, · presence of intrauterine infection, · antibacterial treatment, · pre-, intra- and postnatal care quality. Smaill F.[folk.uio.no]
  • Midtrimester (13-26 wk) PPROM has a poor prognosis, although more recent studies have reported better outcome.[emedicine.medscape.com]
  • Generally, amnioinfusion is used to prevent the poor prognosis of the condition. However, the present study avoided the infusion because of its proven fetal anomalies 6.[ispub.com]
  • Moreover, neonatal intensive care has improved dramatically in recent years, and the prognosis for infected neonates is not so unfavorable as previously reported.[glowm.com]

Etiology

  • The etiology of premature rupture of membranes. Clin Obstet Gynecol 1998;41:810-6. Johnson MJ, Petri M, Witter FR, Repke JT. Evaluation of preterm delivery in a systemic lupus eithematosus pregnancy clinic. Obstet Gynecol 1995;86:396-9.[revista.fecolsog.org]
  • There appears to be no single etiology of preterm PROM.[aafp.org]

Epidemiology

  • Epidemiology PROM occurs in 6-19% of term pregnancies. [ 1 ] P-PROM occurs in 2% of all pregnancies. [ 2 ] P-PROM is associated with 40% of preterm deliveries and can lead to significant morbidity and mortality.[patient.info]
  • ., Luo, X. (2015) Obstetrical Disease Spectrum in China: An Epidemiological Study of 111,767 Cases in 2011.[scindeks.ceon.rs]
  • Epidemiologic characteristics of preterm delivery: etiologic heterogeneity. Am J Obstet Gynecol. 1991;164:467–71. 12. Bendon RW, Faye-Petersen O, Pavlova Z, Qureshi F, Mercer B, Miodovnik M, et al.[aafp.org]
Sex distribution
Age distribution

Pathophysiology

  • European Journal of Obstetrics & Gynecology and Reproductive Biology, 174: 64-69 [ PM ] [ EČ ][ GS ] Choi, Y.Y. (2014) Necrotizing enterocolitis in newborns: update in pathophysiology and newly emerging therapeutic strategies.[scindeks.ceon.rs]
  • […] return to top Pathophysiology Normally, cells of amniotic membrane are programmed to die at term. Cell death activates collagenase, a catabolic enzyme that leads to degradation of the membranes.[sharinginhealth.ca]
  • Complications of Preterm PROM Complications Incidence (%) Delivery within one week 50 to 75 Respiratory distress syndrome 35 Cord compression 32 to 76 Chorioamnionitis 13 to 60 Abruptio placentae 4 to 12 Antepartum fetal death 1 to 2 Risk Factors and Pathophysiology[aafp.org]

Prevention

  • […] may be necessary to prevent further complications).[chw.org]
  • Giving women in high-risk situations (like SRoM for longer than 18 hours) antibiotics when in labour can prevent most newborn GBS infection. In these women, giving antibiotics in labour reduces the risk of GBS from 1 in 476 to 1 in 8351.[newcastle-hospitals.org.uk]
  • What you can do to prevent PROM and PPROM Obtaining good prenatal care, getting adequate nutrition and avoiding smoking could lower your chances of both PROM and PPROM.[whattoexpect.com]
  • US Preventive Services Task Forces. Screening for bacterial vaginosis in pregnancy: recommendation and rationale. Am J Prev Med 2001; 20:59-61.[revista.fecolsog.org]
  • Prevention Both intravaginal progesterone and cervical cerclage are used prophylactically to prevent P-PROM in different circumstances, although evidence is lacking on which is more effective and the relative costs and benefits of each.[patient.info]

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