P.P.R.O.M.
By: Chris Cruz
Beauty
Patient is a 38 year old white female who was 19 weeks a the time of the exam. She is a G4 P3. She was referred to the Women's Institute for what appeared to be oligohydramnios. During the first exam, labs were drawn and a true initial assesment took place. Patient came in 10/12/15 for a follow up exam where she was given her options as to a possible amnioinfusion for confirmation of PROM. At that time she was told that if this was PROM, then she would most likely lose the pregnancy. She took two days to think it over and came back on 10/14/15 for the amnioinfusion.
During the exam, the patient was extremely apprehensive about the procedure. She was reluctant at first, but decided that she needed to know what was going on. Dr. Stephenson administered a local anesthetic to numb the area. She then inserted 20cc of saline mixed with a blue dye via a syringe. The dye was used as a marker to prove if there was truly a ruptured membrane. The patient was also warned that the baby's skin will be tinged blue at birth because of the dye regardless of the outcome.
Dr. Stephenson administered the saline via a catheter under ultrasound guidance. She had a sonographer (Dawn) monitor the insertion site via ultrasound. I was asked to squeeze the saline into the patient and to monitor the drip. It was a time consuming, and meticulous procedure. We would stop constantly to make sure of our bearings withing the womb.