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SEARCH RESULTS FOR: Spontaneous-Rupture-of-Membranes

Spontaneous Rupture of Membranes

Pre-Labour Rupture of Membranes: Pathogenesis and clinical findings Gestational age approaching term (>37 weeks)
Authors: Wendy Xu Reviewers: Riya Prajapati Michelle J. Chen Dr. Jadine Paw* * MD at time of publication
Intrauterine inflammation
Fetal maturation
Fetal growth
Uterine contractions
↑ Pro-inflammatory cytokine & chemokine release in fetal membranes & amniotic fluid
↑ Stretch forces on fetal membranes
↑ Pro-apoptotic factors induces cellular apoptosis of fetal membranes
Changes in collagen and protein composition drive extracellular matrix remodeling in fetal membranes
↓ Tensile strength
Structural weakening of fetal membranes
Occurs primarily in the focal area of fetal membranes overlying the cervix
↑ Matrix metalloproteinases triggers extracellular matrix degradation in fetal membranes
Amnion and choriodecidua separation
Amniotic fluid flows from vagina
Amniotic fluid pools in posterior fornix on speculum exam
Pre-labour rupture of membranes
Membranes rupture before onset of uterine contractions
Chorioamnionitis (infection of the fetal membranes and amniotic fluid)
Neonatal infection
Endometritis (infection of the endometrium)
Amniotic fluid leaks through the cervix
Prolonged rupture of membranes (>18hrs) before delivery
Microbes ascend through vaginal canal
Low amniotic fluid volume on ultrasound
Amniotic fluid (pH 7.0-7.5) mixes with normal vaginal fluid (pH 4.5-6.0) which increases vaginal fluid pH to > 6.5
Positive nitrazine (pH indicator) test
Ion- and estrogen-containing amniotic fluid enters vaginal canal
Ferning (branching pattern) of vaginal fluid under microscope
Accompanies uterine contractions, cervical effacement & cervical dilation
Delivery/birth
Legend:
Pathophysiology
Mechanism
Sign/Symptom/Lab Finding
Complications
Published Oct 4, 2024 on www.thecalgaryguide.com