GynaePulse
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Diagnosis on the spotFree in the app

Leaking fluid — have the waters broken?

Confirm rupture of membranes.

Source: NICE NG25 · NG235

Steps

  1. History: gush or continuous leak, colour, smell.
  2. Sterile speculum: pooling of liquor in posterior fornix (ask her to cough).
  3. No pooling: consider IGFBP-1 or PAMG-1 test (not after bleeding).
  4. Avoid digital VE if preterm and not in labour.
  5. Check temperature, CTG, liquor colour.
PPROM: erythromycin 250 mg QDS for 10 days; steroids if 24–33+6 weeks.
A summary for trained clinicians. Always check the full guideline, the patient in front of you and your hospital's protocol. Spotted an error? Tell us.