18. Counselling
Consider Amnioinfusion
Serial USG
Exclude PPROM
Termination of pregnancy SOS
19. Deliver post term cases
Serial USG and Doppler in IUGR
Conservative management for preterm
prelabor rupture of membranes till 34 weeks
Idiopathic cases: NST, serial USG & BPP
21. USG to exclude placenta
Painting and draping
20 G needle
Connected to sterile tubing, 3 way stopcock
and a 50ml syringe
NS is injected under USG
Anti D SOS
22. Consent
Baseline FHR, vital signs, uterine activity
Monitor FHR and uterine activity
Measure and mark fundal height and reassess
every hour
Notify if
• non resolving variable deceleration even
with 800ml of solution infused
• Non reassuring maternal/fetal response
• Intrauterine pressure> 25mmHg
23. According to
fetal condition and
specific conditions such as
preeclampsia
growth restriction
fetal anomaly
24. Close monitoring by EFM
Rupture the membranes in active phase of
labor
Amnioinfusion in case of meconium staining
If FHR abnormality: immediate CS
25. DFMC
Left lateral position
FHR monitoring
Administration of fluids
Anti D after amnioinfusion SOS
Close monitoring during labour
26. Risk for fetal compromise related to reduced
amniotic fluid volume
Risk for prolonged labor r/t uterine inertia
Risk for infection related to premature
rupture rupture of membranes
Anxiety
Ineffective coping