上海交通大学医学院：《妇产科学》（双语） 22 PREMATURE RUPTURE OF MEMBRANES (PROM)

PREMATURE RUPTURE OF MEMBRANES (PROM) Lin Qi De

PREMATURE RUPTURE OF MEMBRANES (PROM) Lin Qi De

Definition PROM is defined as the rupture of the chorioamniotic membrane before the onset of labor

Definition PROM is defined as the rupture of the chorioamniotic membrane before the onset of labor

Incidence PRoM occurs in about 10%oN15% of all delivery ProM is associated with 10% of term pregnancy

Incidence ▪PROM occurs in about 10%~15% of all delivery ▪PROM is associated with 10% of term pregnancy

Cause of prom Trauma(abdominal striked intensely) Sexual intercourse (particularly in the late gestational weeks) Vaginal infection due to bacte、wrs、70XO、CwV、HPV and aset al Smoking

Cause of PROM ▪ Trauma (abdominal striked intensely) ▪ Sexual intercourse(particularly in the late gestational weeks) ▪ Vaginal infection due to bacteria、virus、TOXO、CMV、HPV and HSV,et al ▪ Smoking

Other >Prior Prom >a short cervical length >Prior preterm delivery Bleeding in early pregancy

▪ Other : ➢Prior PROM ➢A short cervical length ➢Prior preterm delivery ➢Bleeding in early pregancy

Affect of prom on the mothers and infants o Mothers (iNfection intrauterine puerperal (2)Placental abruption (3)Preterm delivery

Affect of PROM on the mothers and infants Mothers: (1) Infection : intrauterine puerperal (2) Placental abruption (3) Preterm delivery

Infants 1) Preterm Baby and their Complications (RDS/ Fetal and Neurologic dysfunction Intracranial hemorrhage) 2)neonatal pneumonia sepsis (3 Pulmonary hypoplasia and fetal compression syndrone (4)Prolapse or compression of umbilical cord (5)Abruptio placenta

Infants: (1) Preterm Baby and their Complications : (RDS / Fetal and Neurologic dysfunction Intracranial hemorrhage) (2) neonatal pneumonia、sepsis (3) Pulmonary hypoplasia and fetal compression syndrone (4) Prolapse or compression of umbilical cord (5) Abruptio placenta

Clinical manifestation (1 Fluid passing through the vagina suddenly and then small amounts of fluid flow through the vagina intermitently, particularly when the le increased of abdorminal pressure(cough, sneeze et al)

Clinical manifestation (1) Fluid passing through the vagina suddenly, and then small amounts of fluid flow through the vagina intermitently, particularly when the increased of abdorminal pressure (cough,sneeze,et al)

(2)Free flowing amniotic fluid (3)Fever heart rate of mother and infants↑/ WBC and crp↑/ Uterine tenderness on palpation

(2) Free flowing amniotic fluid (3) Fever / heart rate of mother and infants ↑ / WBC and CRP ↑/ Uterine tenderness on palpation

Diagnosis (1 Vaginal speculum exam leakage of amniotic fluid (2 )PH determination of vaginal fluid (3)The"fern"test (4)Aminoscopy

Diagnosis (1) Vaginal speculum exam.: leakage of amniotic fluid (2) PH determination of vaginal fluid (3) The “fern” test (4) Aminoscopy