Medicine an Surgery notes

Apr 24th, 2015
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PREMATURE RUPTURE OF MEMBRANES (PROM)Definition:Premature rupture of membranes (PROM): Refers to rupture of the chorioamniotic membranes before the onset of labor at any stage of gestation Preterm PROM: Rupture of the fetal membranes prior to the completion of the 37th week of pregnancyPreterm PROM (PPROM) refers to this occurrence in pregnancies less than 37 weeks of gestation and accounts for 25 percent of cases of PROM. Spontaneous premature rupture of the membranes (SPROM) is ROM after or with the onset of labor. Prolonged ROM is any ROM that persists for more than 24 hours and prior to the onset of laborEpidemiologyThe frequencies of term, preterm, and midtrimester PROM are 8, 1 to 3, and less than 1 percent of pregnancies, respectivelyPROM occurs in about 10%~15% of all deliveryPROM is associated with 10% of term pregnancyEighty-five percent of neonatal morbidity and mortality is a result of prematurity. PPROM is associated with 30-40% of preterm deliveries and is the leading identifiable cause of preterm delivery. PPROM complicates 3% of all pregnanciesWhen PPROM occurs remote from term, significant risks of morbidity and mortality are present for both the fetus and the motherRisk factors1. Maternal infection (e.g. urinary tract infection, lower genital tract infection, sexually transmitted diseases)2. Intrauterine infection 3. Trauma (abdominal striked intensely)4. Cervical incompetency 5. Multiple previous pregnancies 6. Hydramnios 7. Nu

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