Facharzt FMH Gynäkologie Und Geburtshilfe Practice Questions - Facharzt FMH Für Gynäkologie Und Geburtshilfe Spécialiste FMH En Gynécologie Et Obstétrique Exam

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A 26-year-old primigravida at 31+1 weeks of gestation presents with sudden painless pooling of clear fluid from the vagina. Sterile speculum examination confirms clear amniotic fluid pooling in the posterior fornix with positive IGFBP-1 / PAMG-1 rapid test. Maternal temperature is 36.8°C, maternal pulse 76 bpm, and fetal heart rate is 140 bpm with no uterine contractions. Laboratory markers (CRP and leukocyte count) are normal. What is the standard evidence-based management strategy for this patient with preterm premature rupture of membranes (PPROM)?

Immediate labor induction with vaginal dinoprostone to prevent intrauterine infection Hospital admission, administration of antenatal corticosteroids (betamethasone), latency antibiotic therapy (oral erythromycin or IV ampicillin followed by oral amoxicillin), and expectant management with maternal/fetal surveillance until 34–37 weeks Immediate placement of an emergency rescue cervical cerclage to prevent further amniotic leakage Continuous tocolytic therapy with intravenous atosiban for 14 consecutive days until reaching 34 weeks of gestation

Correct Answer:

Hospital admission, administration of antenatal corticosteroids (betamethasone), latency antibiotic therapy (oral erythromycin or IV ampicillin followed by oral amoxicillin), and expectant management with maternal/fetal surveillance until 34–37 weeks

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