ROM (Rupture of Membranes) SROM: Spontaneous Rupture of Membranes water breaks on its own How does it work, does your water break and you go into labor? NO—only about 15% of women break their water and then go into labor; Most women if you leave the bag of water alone will break on its own pretty far into labor sometimes when they are pushing their baby out is when the water will break; “Shrom” AKA water broke on its own AROM: Artificial Rupture of Membranes, via amniotomy We break your water for you with an amni hook—looks like a long crochet hook; long because anything you stick in vaginas has to be long because you need leverage; you snag the bag of water like you snag a pair of panty hose, breaking the bag of water; Most common L & D procedure No pain endings in BOW (bag of water) doesn’t hurt, but you have to have your hand up somebody for a couple of contractions first which isn’t fun for them Amnihook Additional terms: PROM: Premature Rupture of Membranes; more than >1 hour from ROM to labor onset water breaks at noon and at 1 youre not in labor yet…this is PROM PPROM: Preterm, Premature Rupture of Membranes 28 weeks and water breaks we don’t want you to go into labor in the next hour because your only 28 weeks gestation, we want to buy more time; if WAY preterm, we can get another 2-3 weeks out of your pregnancy—it wont be water breaks at 28 weeks and go into labor 12 weeks later on your due date Prolonged ROM: anytime ROM more than >24 hours; increased risk of ascending infection ; hillcrest uses 18 hours because the bag of water is a barrier to infection and if broken we worry about an ascending uterine infection infecting mom and baby; Think of a turkey baster that the tube is the vagina and the bulb is a uterus—there are bacteria that live in the vagina that when the bag is broken can ascend up into the uterus giving the baby an infection ranging from pneumonia to meningitis and infect the mom if water broken a long time people keep coming in to check your cervix which could potentially send organisms upward; Contractions are like squeezing the bulb of the turkey baster causing things to move upward (turkey juices AND organism/infection) o Chorioamnionitis: infected BOW; fever, tenderness uterus , foul-smelling & cloudy amniotic fluid chorion and amnion are the two layers of the bag of water infected bag of water; Not clear, remember it is fetal urine so it will have a slight yellowish tint to it, but NEVER crazy bloody (placental problem,)
only potentially a few streaks from bloody show, but in Chorioamnionitis it is cloudy R/T infection, so your body throws a lot of WBC at the problem, making the amniotic fluid look clouds When your water breaks we know because usually it breaks right over the cervix with a HUGE gush and you are wet to your knees, but sometimes there is a high leak where you dribble on yourself and might think you peed on yourself, or at the end of pregnancy there is a log more vaginal discharge, so they may think they are moist from the extra discharge
You've reached the end of your free preview.
Want to read all 73 pages?
- Fall '19