Preterm Premature Rupture of Membranes(PPROM) : Diagnosis and Management

소개글

Preterm Premature Rupture of Membranes(PPROM), 조기양막파열에 대한 레포트 자료입니다. 정의, 위험인자, 병태생리, 진단방법, 치료방법에 대하여 이해하기 쉽도록 잘 정리된 자료입니다. 임신주수별로 치료 방법에 대하여 교과서 및 최신 논문을 포함한 최신 지견들을 종합하여 잘 정리하였습니다. 발표자료, 레포트 제출용, 공부 자료로 폭넓은 활용이 가능한 고급자료입니다.

목차

Preterm Premature Rupture of Membranes(PPROM) : Diagnosis and Management
1. Definition
2. Complications
3. Risk Factors
4. Pathophysiology
5. Diagnosis
6. Management
- CORTICOSTEROIDS, ANTIBIOTICS, TOCOLYTIC THERAPY
- Membrane Repair
7. Management
- 34~36 WEEKS
- 32~33 WEEKS
- 24~31 WEEKS
- BEFORE 24 WEEKS
8. Recommended Management of Preterm Membrane Rupture at Parkland Hospital and the University of Alabama at Birmingham

본문내용

Preterm Premature rupture of membranes (preterm PROM)
PROM :
the rupture of the fetal membranes before the onset of labor
Preterm PROM :
Definition: when membrane rupture occurs before 37 weeks’ gestation
approximately 3 % of pregnancies
1/3 of preterm births
↑perinatal and neonatal complications
1~2 % risk of fetal death.

Complications
m/c complications : Early Delivery
Latent Period : PROM 발생한 GA에 반비례
Near Term PROM
95 % : 1일내 분만
Preterm PROM (16~26 weeks)
57% : 1주일 내 분만
22% : 4주 이후 분만

<중 략>

Management 34~36 WEEKS
Avoid the urge to prolong pregnancy
Labor induction : clearly beneficial
Not contraindication to V/D
Conservative management : ↑Risk of
Chorioamnionitis, Lower average umbilical cord pH.
Corticosteroids : not indicated
Prophylactic antibiotics for group B streptococcus

Management 32~33 WEEKS
With documented Pulmonary Maturity
Labor induction
Prolonging pregnancy :↑maternal amnionitis, umbilical cord compression, prolonged hospitalization, and neonatal infection.
Without documented Pulmonary Maturity
few data to guide care of patients
a course of corticosteroids and antibiotics

참고 자료

Cunninghum, Williams Obstetrics, 22nd Edition; 2006
TANYA M. MEDINA, M.D., and D. ASHLEY HILL, M.D., Preterm Premature Rupture of Membranes: Diagnosis and Management; Am Fam Physician 2006;73:659-64,665-6
Emma L. Stuart , etc., Reduced Collagen and Ascorbic Acid Concentrations and Increased Proteolytic Susceptibility with Prelabor Fetal Membrane Rupture in Women; BIOLOGY OF REPRODUCTION 2005;72: 230–235