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West Coast University, Orange County - NURS 307OB prework week 5(latest fall 2020/2021)

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Week 5 PreWork Chapter 7 DURHAM: High Risk Antepartum Nursing Care PROM (Premature rupture of membranes) • (ATI): This is the spontaneous rupture of the amniotic membranes 1 hour or more prior to... the onset of true labor. For most women, PROM signifies the onset of true labor if gestational duration is at term. • Rupture of the chorioamniotic membrane before the onset of labor but AT TERM o Prolonged rupture of membrane: >24 hours PROM o Preventable PROM: Rupture of membrane before 23-34 weeks o Preterm PROM remote from term: 24-32 weeks gestation o Preterm PROM near term: 31-36 weeks gestation PPROM (Preterm premature rupture of membranes) • (ATI): is the premature spontaneous rupture of membranes after 20 weeks of gestation and prior to 37 weeks of gestation. • Ruptured membranes with premature gestation of <37 weeks • Latency: time from membrane rupture to delivery • Risk factors for PROM and PPROM: o Previous preterm PROM or preterm delivery o Bleeding during pregnancy o Polyhydramnios o Multiple gestation: 15% in twins, 20% in triplets o STI o Cigarette smoking • Risks for the women: o Maternal infection ▪ Ex.) Chorioamnionitis: intra-amniotic infection (IAI) • There is an increased risk of infection if there is a lag period over the 24 hour period from when the membranes rupture to delivery o Preterm labor and birth o Increased rate of C/S birth o Abruptio placenta and retained placenta • RISKS FOR FETUS/NEWBORN: o Fetal/neonatal sepsis ▪ Earlier the fetal gestation at ROM, greater the risk for infection. ▪ Membrane separates sterile fetus and fluid from bacteria in vaginal canal. o Preterm delivery and complications of prematurity o Hypoxia/asphyxia ▪ umbilical cord compression due to decreased fluid o Fetal deformities ▪ If preterm PROM before 26wks gestation [Show More]

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