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Handbook on Preterm Prelabor Rupture of Membranes in a Low Resource Setting
Shyam V Desai, Parikshit Tank
CHAPTER 1:
Preterm Prelabor Rupture of Membranes: An Introduction
DEFINITIONS
PATHOPHYSIOLOGY OF PPROM
PREDICTION OF PRETERM PROM
DIAGNOSIS
MANAGEMENT
CHAPTER 2:
Etiology of Preterm Premature Rupture of the Membranes (PPROM)
INTRODUCTION
ANATOMY OF FETAL MEMBRANES
PATHOPHYSIOLOGY OF PPROM
ETIOLOGY OF PPROM
Infection
Overdistention of the Uterus
Cervical Causes
Risk Factors for PPROM
Maternal Demographic Factors
Nonwhite Race
Extremes of Maternal Age (<20 or >34)
Socioeconomic Deprivation
Nutritional Status
Social and Behavioral Factors
Past Obstetric History
Current Pregnancy Characteristics
Biological and Genetic Markers
CHAPTER 3:
Diagnosis of Preterm Rupture of Membranes
DIAGNOSIS OF PROM
HISTORY
CLINICAL EXAMINATION
Abdominal Examination
Digital Examination
Diagnosis is Confirmed
Visual Pooling
Nitrazine Test
Fern Test
Other Important Means of Diagnosis
Ultrasound
Nile Blue Sulfate Test
Amnio-dye Test (Tampon Test)
Biochemical Markers
AmniSure ROM Test
Importance of Diagnosis of PPROM
CHAPTER 4:
Management of PPROM at 34 to 36 Weeks of Gestation
CLINICAL DILEMMAS IN LOW RESOURCE SETTINGS
ETIOLOGY
PATHOLOGY
DIAGNOSIS
EVALUATION
Obstetric Decision-Making
Antenatal Steroids
Antibiotic Therapy
Obstetric Management
SPECIAL SITUATIONS
CONCLUSION
CHAPTER 5:
Management of PPROM at 32 to 34 Weeks
MANAGEMENT OF PPROM AT 32 TO 34 WEEKS
EXPECTANT MANAGEMENT
Timing and Route of Delivery
SUMMARY
CHAPTER 6:
Management of PPROM at 28 to 32 Weeks Pregnancy
INTRODUCTION
HOW TO APPROACH?
INITIAL EVALUATION
What is the Usual Course of PPROM?
Counseling
CONTRAINDICATIONS FOR EXPECTANT MANAGEMENT
Expectant Management
Medical Management
Monitoring of Women with PPROM who are Managed Expectantly
WHAT TO DO IF CERCLAGE IN SITU WITH PPROM?
Mode of Delivery
Neonatal Aspects
SUMMARY31
CONCLUSION
CHAPTER 7:
Use of Antibiotics in Preterm Prelabor Rupture of Membranes
INTRODUCTION
EFFICACY OF ANTIBIOTICS
ANTIBIOTICS REGIMEN
Type of Antibiotics
Duration of Antibiotics
GROUP B STREPTOCOCCAL PROPHYLAXIS
CONCLUSION
CHAPTER 8:
Antenatal Corticosteroids in Preterm Prelabor Rupture of Membranes
INTRODUCTION
PATHOPHYSIOLOGY OF IDIOPATHIC RESPIRATORY DISTRESS SYNDROME AND CHRONIC PULMONARY DYSPLASIA
ANTENATAL CORTICOSTEROIDS: SINGLE COURSE
ANTENATAL CORTICOSTEROIDS: REPEAT DOSES
CONCLUSION
CHAPTER 9:
Management of the Fetus and Neonate Born to Mother with Prelabor Rupture of Membranes
INTRODUCTION
INCIDENCE
MATERNAL AND FETAL SURVEILLANCE
MODE OF DELIVERY
MANAGEMENT
Use of Antibiotics
The Oracle Study
ANTIBIOTIC RECOMMENDATIONS
ANTENATAL STEROIDS
THE PRETERM BABY IN A LOW RESOURCE SETTING
CARE OF THE NORMAL NEWBORN AT BIRTH
Postnatal Interventions for Improving Neonatal Health8
Thermal Protection
Early and Exclusive Breastfeeding
CARE OF THE PRETERM NEWBORN
MAJOR RISKS OF EARLY PRETERM DELIVERY
RESPIRATORY DISTRESS SYNDROME
Recent Advances in Management of RDS12
NECROTIZING ENTEROCOLITIS
Treatment
RETINOPATHY OF PREMATURITY
Management
Surgical
CHAPTER 10:
Magnesium Sulfate in the Prevention of Cerebral Palsy in Preterm Fetuses
SAFETY AND COST-EFFECTIVENESS OF THE TRIALS
Safety
Cost-Effectiveness
TAKE HOME MESSAGES
Pediatric Outcomes
Maternal Outcomes
CHAPTER 11:
Prevention of Preterm Prelabor Rupture of Membranes
INTRODUCTION
RISK FACTORS AND PATHOPHYSIOLOGY
MATERNAL FACTORS
Fetal Factors
PREDICTION OF PRETERM LABOR IS DIFFICULT
Identifying the High-risk Factors for Premature Rupture of the Fetal Membranes5
Preventable
Nonpreventable
STRATEGIES TO PREVENT PROM
CONCLUSION
INDEX
TOC
Index
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