Rupture of membranes

Introduction Membrane rupture is one of the important causes of premature birth and neonatal complications, and the fetus is often sent to the NICU (Newborn Intensive Care Unit) for monitoring. Misdiagnosis of PROM can lead to obstetrics not being able to take early measures, and can lead to infections, early childbirth, fetal distress, umbilical cord drooping and placental flaking. When the abdominal pressure increases, such as cough, sneezing, weight-bearing and other amniotic fluid outflow, the anus examination will increase the amount of fluid when the first exposed part of the fetus is pushed up, then the diagnosis can be confirmed.

Cause

Trauma; internal cervix relaxation; mechanical stimulation or fetal membrane inflammation during sexual intercourse in late pregnancy; lower genital tract infection, caused by bacteria, virus or toxoplasma; increased pressure in amniocente (such as multiple pregnancy, polyhydramnios) The fetal first exposed part and the pelvic entrance are not well connected (such as the head basin is not called, the fetal position is abnormal, etc.); the membrane is dysplastic to weak and fragile.

an examination

Related inspection

Vaginal secretion smear examination amniocentesis crystallization examination amniocentesis

When the abdominal pressure increases, such as cough, sneezing, weight-bearing and other amniotic fluid outflow, the anus examination will increase the amount of fluid when the first exposed part of the fetus is pushed up, then the diagnosis can be confirmed.

1. Vaginal pH test: usually the pH value of vaginal fluid is 4.5-5.5, the pH value of amniotic fluid is 7.0-7.5, and the urine is 5.5-6.5. Tested with nitrazine paper, the vaginal fluid is alkaline, and the pH value is 7.0, which is regarded as positive, and it is inclined to amniotic fluid, and the possibility of premature rupture of membranes is extremely high.

2. Vaginal smear examination: The test liquid is dried and examined to have amniotic crystals appearing as amniotic fluid. The smear was stained with 0.5 methylene blue to show light yellow or non-colored fetal skin epithelium and bristles; the orange fat granules were stained with Sudan III, and the yellow fetal epithelial cells were stained with 0.5% Nile Blue sulfate. The pH value is reliable and can be determined as amniotic fluid.

3. Amniocentesis: You can directly look at the exposed part of the fetus, you can not see the anterior amniotic sac, you can confirm the diagnosis.

Differential diagnosis

The diagnosis should be differentiated from the following symptoms:

1. Premature rupture of membranes: rupture of the membrane before labor, known as premature rupture of membranes. The incidence rate varies from report to report, accounting for 2.7% to 17% of the total number of births. It occurs in premature births about 2.5 to 3 times the full-term production. Its adverse effects on pregnancy and childbirth are increased preterm birth rate, increased perinatal mortality, intrauterine infection rate and puerperal infection rate.

When the abdominal pressure increases, such as cough, sneezing, weight-bearing and other amniotic fluid outflow, the anus examination will increase the amount of fluid when the first exposed part of the fetus is pushed up, then the diagnosis can be confirmed.

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