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med:pprom [2018/05/14 17:37] – 만듦 V_Lmed:pprom [2019/06/03 16:25] (현재) – V_L
줄 9: 줄 9:
 In general, the following guidelines should be followed: In general, the following guidelines should be followed:
  
-ROM diagnosis needs to be confirmed. +  * ROM diagnosis needs to be confirmed. 
- +  * Digital vaginal examinations should be avoided. 
-Digital vaginal examinations should be avoided. +  * Ultrasonography should be performed to confirm gestational age, estimated fetal weight, presentation, amniotic fluid index, and fetal anatomy if not already fully evaluated. 
- +  * Antibiotics need to be given based on present evidence.  
-Ultrasonography should be performed to confirm gestational age, estimated fetal weight, presentation, amniotic fluid index, and fetal anatomy if not already fully evaluated. +  * Corticosteroids should be given to accelerate lung maturity between 24 and 34 weeks. 
- +  * Informed consent should be obtained for expectant management versus delivery with careful documentation in the chart.
-Antibiotics need to be given based on present evidence. See Medical Treatment. +
- +
-Corticosteroids should be given to accelerate lung maturity between 24 and 34 weeks. +
- +
-Informed consent should be obtained for expectant management versus delivery with careful documentation in the chart.+
  
 In PPROM, the rule should be hospitalization after viability in an institution where care for a premature neonate can be provided. In PPROM, the rule should be hospitalization after viability in an institution where care for a premature neonate can be provided.
줄 29: 줄 24:
 After 32 weeks' and certainly after 34 weeks' gestation, the appropriateness of expectant management of PPROM should be reevaluated individually for each case. After 32 weeks' and certainly after 34 weeks' gestation, the appropriateness of expectant management of PPROM should be reevaluated individually for each case.
  
-PROM at term should be managed by delivery unless reasons exist to consider waiting for spontaneous labor. Large enough studies to document neonatal safety of expectant management of PROM at term do not exist.+[[PROM]] at term should be managed by delivery unless reasons exist to consider waiting for spontaneous labor. Large enough studies to document neonatal safety of expectant management of PROM at term do not exist.