Following are excerpts from numerous articles on PROM in
Midwifery Today's Wisdom of the Midwives: Tricks of the
Trade Volume II:
A team of nurse-midwives from Cooperstown, NY reported on
the success of an essentially hands-off approach to
premature rupture of membranes (PROM). Where appropriate,
women with ruptured membranes were permitted to wait at home
for labor to start. In the year that the program has been in
effect, it has led to a decreased cesarean section rate
without increase in neonatal or maternal morbidity. Crucial
to the program's success was refraining from performing
digital vaginal exams on women who are not yet in labor....
-CBE Reporter, Sept. 1994
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The cesarean rate is between 30 and 50 percent for women who
were induced to deliver within 24 hours of PROM. Since most
women will spontaneously go into labor within this time
frame, the patient (and wise) birth attendant will wait.
-Yvonne Lapp Cryns
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Teach the parents how to listen to fetal heart tones at
least once a day--it will save you many trips to their home.
Have the mom drink at least four to eight ounces of fluids
per hour, preferably water. The mom should check her
temperature every morning before rising; the reading will be
more accurate than after she has been up and moving around.
Have her take up to 1,000 grams of vitamin C daily. Check
for an amniotic fluid thrill daily. This will tell you if
there is still plenty of water for the baby so the cord does
not become compressed.
Parents can be taught how to do the fluid thrill. Have the
woman relax in a semi-sitting or almost flat position. Put
your hand on one side of her abdomen, flat against it. With
your other hand, very gently flick your finger against her
tummy. You should be able to feel the ripple of the water
against the hand that is flat on her tummy. Do this all
around, feeling for pockets of water, until you have a
general sense of how much water is around the baby. If her
bag is leaking, and if you feel like there is less and less
water as the days elapse, seek medical advice and/or
ultrasound. -Patty Sherman
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A good, healthy diet will help keep the immune system
strong. Have the woman eat a diet low in fat and sweets,
lots of green leafy vegetables, and drink plenty of water or
tea to replenish lost amniotic fluid. Herbs and vitamins
help boost the immune system and fight infection. Have the
woman take 1 tsp. echinacea tincture four times daily, 1/4
tsp. goldenseal powder, twice daily, 4-5 grams vitamin C
daily. -Clarebeth Loprinzi Kassel, CM
Reprinted from Midwifery Today E-News (Vol 2 Issue 27 July 5, 2000)
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