PROM/PPROM 住院診療計劃書
病名
PROM(premature rupture of membrane)
PPROM(preterm with premature rupture of membrane)
住院目的 To evaluate whether there is perinatal infection and prevent
the occurrence of neonatal sepsis
檢查計劃 1.
Evaluation of maternal history and data for evidence
of maternal infection, such as chorioamnionitis、fever、
leukocytiosis、UTI and elevated CRP
2.
Evaluation of baby’s condition for signs of perinatal
infection
3.
Send CBC/DC, CRP, B/C and skin surface culture
from one of the following sites:ear canal、nostrils、
umbilical stump
4.
If there are evidences of materno-fetal infections
→CXR、 ALT、ABG、creatinine should be checked；
consider lumbar puncture if indicated
治療計劃 1.
Therapeutic antibiotics(a course of at least 7 d ) is
indicated in the following conditions:
a. evidence of maternal infection
b. PPROM
c. evidence of neonatal infection either at the base of
clinical manifestation or laboratory evidence of
infection
2.
Prophylactic antibiotics(a course of at least 3 d ) for the
term babies with PROM but without any evidence of
materno-neonatal perinatal infection either from
clinical signs or laboratory data.
3.
Close follow up blood culture, the preliminary result is
after 3 d culture and the final result is after 7 d culture.
4.
Adjust/choose antibiotics according to the culture
result from either mother’s culture or baby’s culture
出院計劃
Discharge after all the following criteria are met
1.
Completion of either therapeutic or prophylactic
antibiotics course
2.
Stable vital signs and feeding well
3.
Normalization of all the abnormal laboratory data
4.
Follow-up at OPD 1 week after discharge
科主任/主治醫師/住院醫師
實習醫師/實習醫學生
護理人員/社工人員/營養師