IN THE NAME OF GOD Dr M Shirazi

PROM ﺗﻌﺮیﻒ ﻭ ﺷیﻮﻉ PROM Premature rupture of membranes: membranes rupture before the onset

PPROM RISK FACTORS Previous preterm delivery Substance abuse Smoking Maternal age (<18 or >40)

Diagnosis History Diagnostic evaluation Physical examination Nitrazine and fern tests Ultrasonography Instillation of indigo

Gestation Age 11 -13 weeks ultrasound LMP < =1 W 1 different ultrasound

MANAGEMENT The management is based upon consideration of several factors : Gestational age Availability

Gestational age greater than 34 weeks Women admitted with PPROM at ≥ 34

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IN THE NAME OF GOD Dr : M. Shirazi, Perinatologist, Associated Professor of Medical Sciences 28/5/95 PROM

PROM ﺗﻌﺮیﻒ ﻭ ﺷیﻮﻉ PROM Premature rupture of membranes: membranes rupture before the onset of uterine contractions. 8%

PPROM RISK FACTORS Previous preterm delivery Substance abuse Smoking Maternal age (<18 or >40) African-American race Poor nutrition and low body mass index Anemia (hemoglobin <10 g/d. L) Excessive uterine contractility Inadequate prenatal care CPD

Diagnosis History Diagnostic evaluation Physical examination Nitrazine and fern tests Ultrasonography Instillation of indigo carmine Amni. Sure

Gestation Age 11 -13 weeks ultrasound LMP < =1 W 1 different ultrasound

MANAGEMENT The management is based upon consideration of several factors : Gestational age Availability of NICU Presence or absence of maternal/fetal infection Presence or absence of labor Fetal presentation FHR tracing pattern Likelihood of fetal lung maturity Cervical status (by visual, not digital, inspection unless induction is planned or the woman is in labor)

Gestational age greater than 34 weeks Women admitted with PPROM at ≥ 34 weeks of gestation are delivered.

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