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DEFINITION OF TERMS
Eighty-five percent of neonatal morbidity and mortality is a result of prematurity. Preterm premature rupture of the membranes (PPROM) is associated with 30-40 percent of preterm deliveries and is the leading identifiable cause of preterm delivery. The 3 most common risk factors for PPROM are smoking, previous preterm delivery, and vaginal bleeding at any time during the index pregnancy.
The terminology pertaining to premature rupture of membranes (PROM) can be confusing, so understanding the subtle distinctions can be valuable. PROM is rupture of the membranes (ROM) prior to the onset of labor. PROM is used appropriately when referring to a patient who is beyond 37 weeks of gestation, has presented with spontaneous rupture of the membranes (SROM), and is not in labor. PPROM is ROM prior to the onset of labor in a patient who is at less than 37 weeks of gestation. PROM is ROM prior to 37 weeks of gestation and may imply that the patient is in labor. This has also been abbreviated as SPROM, ie, spontaneous premature rupture of membranes. Otherwise, this patient is referred to as having PPROM. Prolonged ROM is any ROM that persists for more than 24 hours.
MIDWIFERY NEWBORN MANAGEMENT
1. The midwife should consider collecting cord blood for culture.
2. Assess color, muscle tone and respiration rate hourly. If abnormal, the midwife and/or mother should consult with the newborn's health care provider/pediatrician.
3. Chart newborn body temperature 6 to 8 times in the first 24 hours; the midwife and/or mother should consult with the newborn's health care provider/pediatrician if temperature is greater than 99.5°F.
4. Chart respiration rate 6 to 8 times in first 24 hours; the midwife and/or mother should consult with the newborn's health care provider/pediatrician if respiratory rate (RR) is greater than 60.
MoonDragon MDBS Birthing Guidelines: Variations of Labor & Birth
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