prom - p2

[ArchivalUser]

WHEN TO GIVE TOCOLYSIS IN PROM
KAPLAN SAYS ONCE UTERINE CONTRACTIONS START TOCOLYSIS CONTRAINDICATED
UW SAYS NO UTERINE CONTRAC TOCOLYSIS NEED NOT BE GIVEN

[ArchivalUser]

after prom, u never start tocolysis...

if w/o prom, uterine contr start, then consider gest age and fetal distress for starting tocolysis...

[ArchivalUser]

Hi guys according to Kaplan notes it is a contraindication ( because the most frequent cause of PROM is Chrioamnionitis).in practice still been used by some obstetricians ( controversial), possible indication for Antb or Csteroid ( 24-34 weeks).because most patients remain pregannt 48 hours after PROM.
hope this helps.

[ArchivalUser]

as far as i know...in prom--first see if the pt has contractions--if she has---period --avoid it..(coz memebranes r already ruptured..aminotic fluid is out...so if we prolong labour then it will lead to compression of fetal body parts unless we do amnioinfusion and restore the fluid)

if contractions are absent---then see if pt has infection or not
if infection present--period--giv broad spe antibiotics do cervical cultures and prompt induction of vaginal delivery

if infection is absent--then go acc to gestational age...

[ArchivalUser]

@ harsh/dream

if prom---no contractions--no infection--

[ArchivalUser]

@ harsh/dream

if prom---no contractions--no infection--

[ArchivalUser]

sorry..some problem
@ harsh/dream
if prom---no contractions--no infection--

[ArchivalUser]

and gest age less than 34... wat next?

[ArchivalUser]

ok ...if >24 wks--as it is fetus is gonna die...u can go either way..either initiate delivery or obseervation
if 24-34 weeks--then admit,cervical cultures,ampicillin or eryhtrho.im betamethasone,deliver as soon as fetal lung maturity acheived..
if >34 weeks--delivery after confirmation of fetal maturity...

[ArchivalUser]

oh sorry