Ep 47: Prelabor Rupture of Membranes

07/03/20 • 51 min

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])

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])

Previous Episode

Ep 46: Changing the Culture of Hospital-Based Birth

SPECIAL EPISODE - Interview w/ Hermine Hayes-Klein, JD, and Brad Bootstaylor, MD, FACOG
In this episode, we'll be discussing the problematic culture of hospital-based birth. We explore the physician-patient relationship, the responsibilities that come with the rights to informed consent and refusal of treatment, and how supercomputers in the hands of our patients have enabled them to view us as the enemy, and vice-versa. Most importantly, we discuss ways in which we may all begin to mend the physician-patient relationship in order to redirect the culture of hospital-based birth.
Show Notes
Wine pairing: 2017 Sauvignon Blanc from Psyche Wines
Theme music by Evan Handyside
Logo design by JD Dotson ([email protected])

Next Episode

Ep 48: Chronic Pelvic Pain

Practice Bulletins #218 - Published March 2020
1. Up to 33% of women with chronic pelvic pain will also meet criteria for diagnosis of major depression
2. An interdisciplinary approach is the way go to: gynecologist, physical therapist, and psychologist in the very least.
3. The physical exam should be approached very carefully and systematically
4. Yoga, acupuncture, and other complementary and integrative therapies should absolutely be considered.
5. Don't prescribe opioids for chronic pelvic pain. Go with neuropathic agents, SNRIs, and tricyclic antidepressants.
Show Notes
**Visit our friends at www.intimatewellnessshop.com for bushels of sex positivity, including toys, massage oils, self-care products, and more! Use code MOREWINE at checkout for 15% off your purchase!**
Wine pairing: 2017 Red Blend from Francis Coppola
Theme music by Evan Handyside
Logo design by JD Dotson ([email protected])