Quiz: Premature Rupture of Membranes (PROM)

1. Prolonged rupture of membranes: rupture of membranes > . . . . hours without labor:

a. 6.

b. 12.

c. 24.

d. 48.

>> c

2. Regarding PROM, which of the following statements is INCORRECT:

a. It is a high-risk pregnancy.

b. It is one of the causes of preterm labor.

c. It is one of the causes of postpartum hemorrhage.

d. At least one of the above is incorrect.

>> c

3. PROM is the rupture of membranes when the fetus is preterm:

a. True.

b. False.

>> b

4. Premature rupture of membranes is the rupture of membranes when the fetus is at term:

a. True.

b. False.

>> b

5. The function of amniotic fluid is:

a. Nourishment for the fetus.

b. Protection of the fetus from trauma.

c. Helps the fetus to position itself well.

d. All of the above are correct.

>> d

6. Regarding PROM, which of the following statements is INCORRECT:

a. Most of the causes are due to urinary tract infections.

b. It is a cause of preterm labor.

c. Abnormal presentation can cause PROM.

d. At least one of the above is incorrect.

>> a

7. The risks that can occur after PROM are:

a. Fetal growth restriction in utero.

b. Placental abruption.

c. Umbilical cord knot.

d. Postpartum hemorrhage.

>> b

8. PROM diagnosis must be based on laboratory testing:

a. True

b. False

>> b

9. At term (> 37 weeks), after the rupture of membranes, most (90%) will have the onset of labor within . . . . . . hours:

a. 6 hours.

b. 12 hours.

c. 18 hours.

d. 24 hours.

>> d

10. Nitrazine test: Dip the test paper (yellow) into the fluid, if the test paper changes color to . . . . . . , the membranes have ruptured:

a. Purple.

b. Brown.

c. Deep blue.

d. Red.

>> c

11. The Nitrazine test is based on the fact that amniotic fluid is . . . . . . :

a. Acidic.

b. Contains a lot of protein.

c. Alkaline.

d. Contains Döderlein bacteria.

>> c

12. PROM needs to be differentiated from:

a. Urinary incontinence.

b. Leukorrhea.

c. Cervical mucus.

d. All of the above are correct.

>> d

13. Regarding PROM:

a. It only occurs in cases with a history of preterm labor.

b. It can be diagnosed clinically.

c. The Nitrazine test relies on the acidic pH of amniotic fluid.

d. PROM can cause umbilical cord prolapse into the vagina.

>> b

14. Factors to be evaluated before deciding on the treatment of PROM:

a. Fetal weight.

b. Gestational age.

c. Fetal presentation.

d. Degree of fetal descent.

>> b

15. Issues that need to be identified and managed when there is premature rupture of membranes:

a. Umbilical cord prolapse.

b. Chorioamnionitis.

c. Whether or not there is labor.

d. All of the above are correct.

>> d

16. Premature rupture of membranes has . . . . types:

a. 2.

b. 3.

c. 4.

d. 5.

>> a

17. Umbilical cord prolapse is more common in premature rupture of membranes than PROM:

a. True

b. False

>> a

18. Which of the following methods to reduce the risk of chorioamnionitis in PROM is INCORRECT:

a. Limit vaginal examinations.

b. Use prophylactic broad-spectrum antibiotics.

c. Induce labor immediately after the rupture of membranes.

d. Use sanitary pads.

>> c

19. Dosage of Betamethasone (lung maturity medication):

a. 12 mg/ 24 hours x 2 days.

b. 12 mg/ 12 hours x 2 days.

c. 6 mg/ 12 hours x 2 days.

d. 6 mg/ 24 hours x 2 days.

>> a

20. Dosage of Dexamethasone (lung maturity medication):

a. 12 mg/ 24 hours x 2 days.

b. 12 mg/ 12 hours x 2 days.

c. 6 mg/ 12 hours x 2 days.

d. 6 mg/ 24 hours x 2 days.

>> c

21. Lung maturity medication is most effective after . . . hours of the last injection:

a. 12.

b. 24.

c. 36.

d. 48.

>> b

22. . . . . . . . . . . can prevent PROM:

a. Prolactin.

b. Progestatif.

c. Progesterone.

d. Progestin.

>> c

23. Regarding PROM, which of the following statements is INCORRECT:

a. It is one of the causes of preterm labor.

b. Urinary tract infections are a common cause of PROM.

c. PROM is a high-risk pregnancy.

d. Umbilical cord prolapse into the vagina does not occur in PROM.

>> b

24. PROM is more susceptible to chorioamnionitis than premature rupture of membranes:

a. True

b. False

>> a

25. Antibiotics used in PROM are usually therapeutic antibiotics:

a. True

b. False

>> b

26. Regarding “Lung Maturity Medication”, which of the following statements is INCORRECT:

a. It is usually not used in premature rupture of membranes.

b. The gestational age for use is usually 24 – 34 weeks.

c. It is only used when there is no chorioamnionitis.

d. At least one of the above is incorrect.

>> a

27. Lung maturity medication:

a. Reduces the incidence of fetal distress during labor.

b. Reduces the risk of pneumonia if there is chorioamnionitis.

c. Increases the fetal respiratory rate after birth.

d. All of the above are incorrect.

>> d

28. Inducing labor is only used in cases of “PROM + term pregnancy”:

a. True

b. False

>> b

29. Regarding rupture of membranes:

a. Chorioamnionitis is the earliest complication after premature rupture of membranes.

b. Multiparity is one of the causes of PROM.

c. Dexamethasone is a medication used to stimulate fetal lung maturity in cases of preterm labor with ruptured membranes.

d. The longer the membranes rupture, the higher the risk of fetal distress.

>> c

30. Fetal distress in PROM is often due to:

a. Fetal lung compression.

b. Umbilical cord prolapse outside the vagina.

c. Umbilical cord compression.

d. Chorioamnionitis causing fetal pneumonia.

>> c

31. Regarding treatment in rupture of membranes:

a. Antibiotics are only used in PROM.

b. Lung maturity medication is only used when the fetus is < 32 weeks.

c. Cesarean delivery is only indicated when there is chorioamnionitis.

d. All of the above are incorrect.

>> d

32. Cervical mucus can cause a false-positive Nitrazine test:

a. True

b. False

>> a

33. Factors to be evaluated when treating a case of PROM, CHOOSE THE INCORRECT ONE:

a. Gestational age in weeks.

b. Whether or not there is labor.

c. Whether or not there is chorioamnionitis.

d. At least one of the above is incorrect.

>> d

34. Which of the following causes of PROM is INCORRECT:

a. History of gestational diabetes.

b. Maternal smoking.

c. Multiple pregnancies.

d. Polyhydramnios.

>> a

35. Regarding PROM, which of the following statements is INCORRECT:

a. PROM is a high-risk pregnancy.

b. It needs to be differentiated from urinary incontinence.

c. The longer the membranes rupture, the higher the risk of cesarean delivery.

d. The Nitrazine test is used to diagnose ruptured membranes.

>> a

36. Lung maturity medication is contraindicated when there is chorioamnionitis.

a. True

b. False

>> a

37. Lung maturity medication is not used when there is chorioamnionitis because it will . . . :

a. Reduce the effectiveness of antibiotics.

b. Reduce uterine contractions.

c. Reduce fetal breathing.

d. All of the above are incorrect.

>> d

38. To reduce the risk of chorioamnionitis after rupture of membranes, which of the following statements is INCORRECT:

a. Limit vaginal examinations.

b. Cleanse the vagina with antiseptic solution.

c. Use prophylactic antibiotics.

d. At least one of the above is incorrect.

>> b

40. Regarding the diagnosis of ruptured membranes, which of the following statements is INCORRECT:

a. It can be diagnosed clinically.

b. The Nitrazine test is a test used to diagnose ruptured membranes.

c. Vaginal discharge testing can help diagnose PROM.

d. It needs to be differentiated from urinary incontinence.

>> c

41. Regarding PROM:

a. It only occurs in cases of preterm labor.

b. Chorioamnionitis can be prevented by using prophylactic broad-spectrum antibiotics.

c. Lung maturity medication should not be used when the fetus is > 32 weeks.

d. All of the above are correct.

>> b

42. Regarding premature rupture of membranes:

a. It only occurs in cases with a term pregnancy.

b. The most dangerous complication is chorioamnionitis.

c. All cases of premature rupture of membranes require cesarean delivery.

d. All of the above are incorrect.

>> d

43. Regarding rupture of membranes:

a. To avoid the risk of chorioamnionitis, cesarean delivery should be performed when the membranes rupture for > 12 hours without vaginal delivery.

b. Cesarean delivery should be performed in cases of abnormal presentation (term pregnancy).

c. PROM is more difficult to diagnose clinically than premature rupture of membranes.

d. When there is chorioamnionitis, lung maturity medication should be given orally.

>> b

44. Regarding PROM, which of the following statements is INCORRECT:

a. It is a high-risk pregnancy.

b. History of multiple abortions is a predisposing factor.

c. It can lead to chorioamnionitis.

d. It can cause placental abruption.

>> b

45. Regarding rupture of membranes:

a. Progesterone can prevent PROM.

b. It can cause fetal distress due to umbilical cord compression.

c. It can cause chorioamnionitis.

d. All of the above are correct.

>> d

46. After premature rupture of membranes in a term pregnancy, cesarean delivery is indicated when:

a. Umbilical cord prolapse with a pulsating cord.

b. Abnormal presentation.

c. History of cesarean delivery.

d. All of the above are correct.

>> d

47. Regarding rupture of membranes, which of the following statements is INCORRECT:

a. Gestational age is a factor in determining the specific management.

b. Chorioamnionitis only occurs in women with vaginal infections during pregnancy.

c. Spontaneous labor can occur after rupture of membranes.

d. Ruptured membranes will make the fetus less well-positioned.

>> b

48. When membranes rupture:

a. It can cause umbilical cord prolapse.

b. It can cause chorioamnionitis.

c. It can cause fetal distress.

d. All of the above are correct.

>> d

49. Regarding PROM:

a. It is one of the causes of preterm labor.

b. The longer the time between membrane rupture and labor, the younger the fetus.

c. PROM in a preterm fetus is a high-risk pregnancy.

d. All of the above are correct.

>> d

50. Regarding lung maturity medication:

a. Time of use: 24 – 34 weeks of gestation.

b. Betamethasone 12mg/24 hours x 2 days.

c. The medication is most effective after 24 hours of the last injection.

d. All of the above are correct.

>> d

51. For fetuses over 39 weeks, which cases require termination of pregnancy without waiting for labor when PROM occurs:

a. Transverse lie.

b. Twin pregnancy in a single amniotic sac.

c. Frank breech presentation.

d. All of the above are correct.

>> d

52. Regarding PROM:

a. It is a high-risk pregnancy.

b. It is one of the causes of post-term pregnancy.

c. It is one of the causes of postpartum hemorrhage.

d. All of the above are incorrect.

>> d

53. The function of amniotic fluid is, CHOOSE THE INCORRECT ONE:

a. Nourishment for the fetus.

b. Protection of the fetus from trauma.

c. Regulates the fetal body temperature.

d. Prevents umbilical cord compression.

>> c

54. The function of amniotic fluid is:

a. Reduces the risk of the umbilical cord wrapping around the neck.

b. Protection of the fetus from trauma.

c. Regulates the fetal body temperature.

d. Reduces the risk of the umbilical cord being truly knotted.

>> b

55. Regarding PROM:

a. It is one of the 5 obstetric emergencies.

b. It is one of the causes of post-term pregnancy.

c. It is one of the causes of postpartum hemorrhage.

d. All of the above are incorrect.

>> d

57. The function of amniotic fluid is, CHOOSE THE INCORRECT ONE:

a. Helps the fetus position itself well.

b. Prevents umbilical cord compression.

c. Reduces the risk of the umbilical cord wrapping around the neck.

d. Helps the fetus develop its organs.

>> c

58. Factors to be evaluated when treating a case of PROM, CHOOSE THE INCORRECT ONE:

a. Gestational age in weeks.

b. Stage of labor.

c. Whether or not there is chorioamnionitis.

d. Whether or not there is fetal distress.

>> d

59. Regarding PROM:

a. It only occurs in women with a history of multiple abortions.

b. It can be diagnosed clinically.

c. The Nitrazine test relies on the acidic pH of amniotic fluid.

d. PROM can cause umbilical cord prolapse into the vagina.

>> b

60. The function of amniotic fluid is:

a. Reduces the risk of the umbilical cord being truly knotted.

b. Protection of the fetus from trauma.

c. Regulates the fetal body temperature.

d. Reduces the risk of the umbilical cord wrapping around the neck.

>> b

61. Regarding PROM:

a. It only occurs in cases with a history of PROM.

b. It cannot be diagnosed clinically.

c. The Nitrazine test relies on the acidic pH of amniotic fluid.

d. Premature rupture of membranes can cause umbilical cord prolapse into the vagina.

>> d

62. Factors to be evaluated when treating a case of PROM, CHOOSE THE INCORRECT ONE:

a. Gestational age in weeks.

b. Whether or not there is labor.

c. Whether the amniotic fluid is cloudy or clear.

d. Whether or not there is chorioamnionitis.

>> c

63. Regarding premature rupture of membranes, CHOOSE THE INCORRECT ONE:

a. The most dangerous complication is umbilical cord prolapse.

b. It can only be diagnosed when the membranes rupture during the active stage of labor.

c. Cases of twin pregnancy in a single amniotic sac with premature rupture of membranes should be managed with cesarean delivery.

d. To reduce the risk of chorioamnionitis, broad-spectrum prophylactic antibiotics should be given.

>> c

64. The function of amniotic fluid is, CHOOSE THE INCORRECT ONE:

a. Nourishment for the fetus.

b. Protection of the fetus from trauma.

c. Helps the fetus position itself well.

d. Reduces the risk of the umbilical cord wrapping around the neck.

>> d

65. The function of amniotic fluid is:

a. Helps the fetus position itself well.

b. Prevents umbilical cord compression.

c. Helps the fetus develop its organs.

d. All of the above are correct.

>> d

66. Regarding PROM, CHOOSE THE INCORRECT ONE:

a. It only occurs in cases with a history of PROM.

b. It can be diagnosed clinically.

c. The Nitrazine test relies on the alkaline pH of amniotic fluid.

d. Premature rupture of membranes can cause umbilical cord prolapse into the vagina.

>> a

67. Which of the following methods to reduce the risk of chorioamnionitis in PROM is INCORRECT:

a. Limit vaginal examinations.

b. Use broad-spectrum therapeutic antibiotics intravenously.

c. Use sanitary pads.

d. At least one of the above is incorrect.

>> b

68. Regarding premature rupture of membranes:

a. It can only be diagnosed when the membranes rupture during the active stage of labor.

b. The most dangerous complication is the umbilical cord being truly knotted.

c. All cases of premature rupture of membranes require cesarean delivery.

d. All of the above are incorrect.

>> d

69. Regarding PROM, CHOOSE THE INCORRECT ONE:

a. It can be diagnosed clinically.

b. It only occurs in women with a history of multiple abortions.

c. The Nitrazine test relies on the alkaline pH of amniotic fluid.

d. Premature rupture of membranes can cause umbilical cord prolapse into the vagina.

>> b

70. Methods to reduce the risk of chorioamnionitis in PROM:

a. Limit vaginal examinations.

b. Use prophylactic broad-spectrum antibiotics.

c. Use sanitary pads.

d. All of the above are correct.

>> d

71. Methods to reduce the risk of chorioamnionitis in PROM:

a. Vaginal examinations every 30 minutes.

b. Use prophylactic broad-spectrum antibiotics intravenously.

c. Induce labor immediately after the rupture of membranes.

d. Use sanitary pads.

>> d

72. Which of the following methods to reduce the risk of chorioamnionitis in PROM is INCORRECT:

a. Limit vaginal examinations.

b. Culture vaginal discharge immediately after rupture of membranes.

c. Use prophylactic broad-spectrum antibiotics.

d. At least one of the above is incorrect.

>> b

73. Factors to be evaluated when treating a case of PROM, CHOOSE THE INCORRECT ONE:

a. Whether or not the Nitrazine test was performed.

b. Whether or not there is labor.

c. Whether or not there is chorioamnionitis.

d. Gestational age in weeks.

>> a

74. Factors to be evaluated when treating a case of PROM:

a. Gestational age in weeks.

b. Whether the Nitrazine test is negative or positive.

c. Stage of labor.

d. Whether the amniotic fluid is cloudy or clear.

>> a

75. Regarding premature rupture of membranes, CHOOSE THE INCORRECT ONE:

a. It can occur in cases of preterm labor.

b. The most dangerous complication is chorioamnionitis.

c. Cases with a history of cesarean delivery (term pregnancy) should be managed with cesarean delivery.

d. To reduce the risk of chorioamnionitis, broad-spectrum prophylactic antibiotics should be given.

>> b

76. The function of amniotic fluid is, CHOOSE THE INCORRECT ONE:

a. Prevents umbilical cord compression.

b. Helps the fetus position itself well.

c. Helps the fetus to flex well.

d. Helps the fetus develop its organs.

>> c

77. The function of amniotic fluid is, CHOOSE THE INCORRECT ONE:

a. Prevents umbilical cord compression.

b. Helps to hear the fetal heart clearly.

c. Helps the fetus position itself well.

d. Helps the fetus develop its organs.

>> b

78. The function of amniotic fluid is, CHOOSE THE INCORRECT ONE:

a. Prevents umbilical cord compression.

b. Protects the fetus from trauma.

c. Helps the fetus position itself well.

d. Reduces the risk of gastrointestinal malformations in the fetus.

>> d

79. Which of the following causes of PROM is INCORRECT:

a. History of preterm labor.

b. History of multiple miscarriages.

c. Vaginal infection.

d. Polyhydramnios.

>> b

80. Which of the following causes of PROM is INCORRECT:

a. History of preterm labor.

b. History of PROM.

c. History of vaginal infection.

d. Polyhydramnios.

>> c

81. Which of the following causes of PROM is INCORRECT:

a. Low socioeconomic status.

b. History of preterm labor.

c. History of multiple miscarriages.

d. Polyhydramnios.

>> c

82. Which of the following causes of PROM is INCORRECT:

a. Low socioeconomic status.

b. History of preterm labor.

c. Vaginal infection.

d. Oligohydramnios.

>> d

83. Which of the following is a cause of PROM:

a. History of multiple miscarriages.

b. History of vaginal infection.

c. Low socioeconomic status.

d. Oligohydramnios.

>> c

84. Which of the following causes of PROM is INCORRECT:

a. Short cervical length in the current pregnancy.

b. Polyhydramnios, multiple pregnancies.

c. History of multiple miscarriages.

d. Abnormal presentation.

>> c

85. After rupture of membranes, the risk of chorioamnionitis (considering each factor separately), CHOOSE THE INCORRECT ONE:

a. Increases with the duration of membrane rupture.

b. Increases with gestational age (39 weeks has a higher risk than 38 weeks).

c. Increases with the number of vaginal examinations.

d. Decreases with the use of prophylactic antibiotics.

>> b

86. After rupture of membranes, the risk of chorioamnionitis (considering each factor separately), CHOOSE THE INCORRECT ONE:

a. Increases with the duration of membrane rupture.

b. Increases with gestational age (39 weeks has a higher risk than 38 weeks).

c. Increases with the number of vaginal examinations.

d. Decreases with the use of prophylactic antibiotics.

>> b

87. After rupture of membranes, the risk of chorioamnionitis (considering each factor separately):

a. Increases with the duration of placental delivery (the longer the placental delivery, the higher the risk of chorioamnionitis).

b. Increases with gestational age (39 weeks has a higher risk than 38 weeks).

c. Increases with the number of vaginal examinations.

d. Decreases with vaginal cleansing using Betadine.

>> c

88. After PROM, to reduce the risk of chorioamnionitis:

a. Increase contractions to terminate the pregnancy immediately.

b. Perform cesarean delivery immediately.

c. Use prophylactic broad-spectrum antibiotics intravenously.

d. All of the above are incorrect.

>> d

89. In term pregnancies (≥ 37 weeks), approximately 90% of cases will go into labor within . . . . hours.

a. 6

b. 12

c. 24

d. 48

>> c

90. Regarding premature rupture of membranes: #

a. Prophylactic antibiotics are not necessary because labor has already begun.

b. Multiple vaginal examinations increase the risk of chorioamnionitis.

c. The vagina should be disinfected with antiseptic solution (Betadine).

d. Increase contractions if the membranes rupture for > 6 hours without delivery.

>> b

91. Regarding PROM at 3 hours, which case requires induction of labor: #

a. 34 weeks gestation (cephalic presentation) + AFI = 8

b. 38 weeks gestation breech presentation with incomplete breech (ultrasound)

c. 38 weeks gestation + history of cesarean delivery 12 months ago

d. All of the above are incorrect.

>> d

92. Regarding the Nitrazine test:

a. It is a test used to definitively diagnose PROM.

b. It is a test used to differentiate between amniotic fluid and leukorrhea.

c. It is a test only used when PROM is suspected clinically in gestational ages < 32 weeks.

d. All of the above are incorrect.

>> d

93. Regarding the Nitrazine test, when membranes rupture, dip the test paper into the fluid:

a. Yellow changes to dark red.

b. Yellow changes to deep blue.

c. Deep blue changes to yellow.

d. Does not change color.

>> b

94. The Nitrazine test will help: #

a. Definitively diagnose ruptured membranes.

b. Predict the possibility of chorioamnionitis after rupture of membranes.

c. Predict the possibility of terminating pregnancy via vaginal delivery after rupture of membranes.

d. All of the above are incorrect.

>> a

95. When membranes rupture prematurely, it is necessary to determine whether or not there is umbilical cord prolapse into the vagina because: #

a. Umbilical cord prolapse increases the risk of chorioamnionitis.

b. It threatens the life of the fetus.

c. It affects cervical dilation.

d. It affects the degree of fetal descent.

>> b

96. Umbilical cord prolapse is a “obstetrical emergency” with the condition: #

a. > 37 weeks gestation + incomplete breech presentation.

b. > 37 weeks gestation + evidence of chorioamnionitis.

c. > 37 weeks gestation + normal fetal heart rate within normal limits.

d. > 37 weeks gestation + yellow amniotic fluid.

>> a

97. When there is chorioamnionitis after PROM, which of the following management strategies is INCORRECT: #

a. Induce labor to terminate the pregnancy.

b. Use therapeutic antibiotics, broad-spectrum, intravenous route.

c. Perform cesarean delivery if the conditions for labor induction are not met.

d. Increase the corticosteroid dosage by 2 times to help the fetal lungs mature faster.

>> d

98. When there is chorioamnionitis after PROM:

a. Induce labor.

b. Cleanse the vagina with antiseptic solution.

c. Use prophylactic broad-spectrum antibiotics.

d. Use Betamethasone 12mg/24 hours x 2 days.

>> a

99. Lung maturity medication SHOULD NOT be used when there is chorioamnionitis because: #

a. It reduces the effectiveness of prophylactic antibiotics.

b. It increases the risk of fetal infection.

c. It increases the risk of abdominal infection if cesarean delivery is performed.

d. All of the above are incorrect.

>> b

100. Regarding PROM, CHOOSE THE INCORRECT ONE:

a. It is a high-risk pregnancy.

b. It is one of the 5 obstetric emergencies.

c. It is a cause of preterm labor.

d. There are many causes of PROM.

>> b

39. Regarding lung maturity medication:

a. It is only used after the membranes rupture for > 6 hours.

b. Dosage of Betamethasone 12 mg/ 24 hours.

c. It is only used when the fetus is 28 – 34 weeks gestation.

d. All of the above are incorrect.

>> b

56. Regarding PROM:

a. It only occurs in cases with a history of preterm labor.

b. It cannot be diagnosed clinically.

c. The Nitrazine test relies on the acidic pH of amniotic fluid.

d. PROM cannot cause umbilical cord prolapse into the vagina.

>> d