Preterm birth care is a set of windows that close. Corticosteroids need 24 hours to start working. Rh(D) immune globulin needs to be given before sensitisation and within 72 hours of the event. Group B streptococcal prophylaxis needs 4 hours in the circulation before birth. Run a PPROM admission day by day until infection ends it, calculate how many doses a fetomaternal haemorrhage actually needs, and decide prophylaxis from culture status, risk factors and allergy.
Choose your bench
Antenatal ward · 31 weeks and 2 days · gravida 2 para 1
A gush of clear fluid two hours ago
No contractions. She is afebrile, the fetal heart rate baseline is 148 with moderate variability, and the fluid on the pad is clear with no odour. The unit has no neonatal intensive care above 32 weeks.
Act in whatever order you think is right. Two of these buttons will harm the patient.
Kleihauer-Betke: how many doses?
One 300-microgram dose neutralises approximately 30 mL of fetal whole blood, which is 15 mL of fetal red cells.
Other indications and risk factors
Allergy and dosing
Prophylaxis is intrapartum, not antenatal — antenatal treatment does not prevent recolonisation.
The PPROM admissionConfirm, protect, and watch for infection