Ep 47: Prelabor Rupture of Membranes

Practice Bulletins #188 - Published January 2018
1. Management recommendations in PROM/PPROM is dependent on gestational age:

• >37 0/7 wga => induction/augmentation
  34 0/7 - 36 6/7 wga => expectant management or induction/augmentation
  <34 0/7 wga => expectant management
  2. Diagnosis of PROM is based on history and physical: pooling of fluid, pH of vaginal fluid, and ferning on microscopy.
  3. Indications for induction/augmentation for both PROM and PPROM include abnormal fetal testing, evidence of intra-amniotic infection, and vaginal bleeding suggestive of abruptio placentae.
  4. For PPROM (24 0/7 - 33 6/7 wga) --> antibiotics and steroids should be offered, and magnesium sulfate should be offered at <32 wga
  5. The diagnosis of periviable ROM is best followed up with careful counseling around the risks and benefits. It can be managed with induction or expectant management, which, after hospital assessment, can be provided via home care until viability
  Show Notes
  Wine pairing: 2019 Malbec from Espuela del Gaucho
  Theme music by Evan Handyside
  Logo design by JD Dotson ([email protected])