Clinical Case Study: Premature Rupture of Membranes (PROM)

Flashcards reviewing the clinical presentation, obstetric history, examination findings, diagnostic workup, differential diagnosis, and management of Premature Rupture of Membranes (PROM).

What are the patient's demographic details including name, age, residence, and occupation?

Name: Amina Hassan Abdullahi Elmi; Age: 27 years; Residence: Abdiaziz Region: Banaadir; Occupation: housewife; Education: Quran; Marital status: Married.

What are the obstetric details regarding Gravida, Parity, and Gestational Age for Amina Hassan Abdullahi Elmi upon admission?

Gravida: 2, Parity: 1, Gestational age: 37 weeks and 2 days.

What is the chief complaint reported by the patient?

Vaginal fluid Leakage for 10 hours.

How is the onset and character of the vaginal fluid leakage described in the History of Present Illness?

It began suddenly around 4:00 AM while getting out of bed as a gush of clear, watery fluid that soaked her clothes and bedsheets. She continued to experience intermittent leakage of smaller amounts when standing, walking, or changing position.

What are the specific physical characteristics of the leaked fluid mentioned in the history?

The fluid is clear, watery, and non-offensive in smell, with no history of greenish, yellowish, or blood-stained discharge.

What were the patient's vital signs recorded upon admission?

BP: 118/72 mmHg, Pulse Rate: 88 bpm, Temperature: 37.1°C, Respiratory Rate: 18/min, SpO₂: 98% on room air.

What were the auscultation findings for bowel sounds and fetal heart rate during physical examination?

Bowel sounds were present and normal. Fetal heart sounds were present and regular at 142 beats/minute.

What were the key findings of the gynecological ultrasound?

Single live intrauterine pregnancy at 37 weeks + 2 days in cephalic presentation, FHR 142 bpm, appropriate growth for gestational age, reduced amniotic fluid consistent with ruptured membranes, normally located placenta, and no obvious fetal congenital abnormality.

What were the patient's Complete Blood Count (CBC) laboratory results?

Hb: 11.4 g/dL, WBC: 8,900/µL, Platelets: 238,000/µL, Hct: 34%, Neutrophils: 65%, Lymphocytes: 30%.

What were the patient's blood group and viral marker test results?

Blood Group: O Positive (O+); HBsAg: Negative; Anti-HCV: Negative.

What conditions were listed in the differential diagnosis for this patient?

Premature Rupture of Membranes (PROM), urinary incontinence, physiological vaginal discharge (Leukorrhea), Vaginitis, Cervicitis, and Vesicovaginal Fistula.

What is the patient's final diagnosis?

Premature Rupture of Membranes (PROM).

What medications and IV fluids were prescribed in the hospital management plan?

Misoprostol 600 micrograms (mcg) sublingual every 4 hours, Lactated Ringer's 500 mL IV as indicated, and Ceftriaxone 1 g IV/IM according to protocol.

What is the patient's history regarding her previous pregnancy?

Gravidity: 2, Parity: 1, Living: 1, Neonatal death: 0, Mode of delivery: Spontaneous vaginal delivery (SVD), Abortion: 0, Complications: No preeclampsia, no Gestational Diabetes, no stillbirth, no perineal tear.

What contraceptive history was reported by the patient?

She previously used oral contraceptive pills for birth spacing between her first and second pregnancies and discontinued them before conceiving the current pregnancy, with no history of contraceptive complications.