src/processed_markdown/PROM/PROM.md

---\n\ncitation: "PROM"\n\n---\n\nManagement of preterm rupture of membranes

PRESENTATION i. Sudden leakage of amniotic o Check for pooling of amniotic fluid fluid, which may be o Check for leakage of amniotic fluid from intermittent or continuous. ii. Feeling of wetness. sensation of inability to stop urination - HISTORY cervical os with coughing or fundal pressure o Perform speculum examination for evidence of cervical dilatation under strict aseptic conditions. o Perform ultrasonography for amniotic fluid EXAMINATION index IF PROM CONFIRMED IF PROM NOT CONFIRMED Discharge patient home after observing for 24 hours • Fetal heart tracing is normal • No evidence of Preterm labour Look for evidence of o Intra-amniotic infection o Non-reassuring fetal heart tracing o Abruption o Cord prolapse o Active labour. VOG decision. Depending on No Yes maturity & neonatal facilities To deliver Manage conservatively Send to unit with better neonatal facilities Management in specialist units 24 TO 31 WEEKS OF GESTATION • Administer corticosteroids • Administer Management depending on D o c u m e n t a t i o n M a n d a t o r y

antibiotics

• Deliver at 34

32 TO 34 WEEKS OF

GESTATION

the condition

weeks if lung

maturity is

• Administer

indicated by

amniocentesis(Z)

amniocentesis(Z)

corticosteroids

• Administer antibiotics

• Consider

amniocentesis(Z)

34 TO

36 WEEKS OF

GESTATION

• Administer antibiotics for

GBS prophylaxis

• Steroid therapy - optional

Ew

Send to unit with better neonatal

facilities when necessary

Delivery

Sri Lanka College of Obstetrics and Gynaecology Health sector development Project Guidelines- Management of preterm rupture of membranes