Question

A 25-year-old G2P1 woman at 20 weeks gestation is diagnosed with preterm premature rupture of the membranes. She denies labor. She takes prenatal vitamins and iron. She denies substance abuse, smoking or alcohol use. Her prior pregnancy was delivered vaginally at 36 weeks after preterm rupture of membranes. Her blood pressure is 110/70; pulse 84; temperature 98.6°F (37.0°C). The patient's fetus is greatest risk for which of the following?

1) Pulmonary hypoplasia
2) Cardiac anomalies
3) Urinary tract anomalies
4) Microcephaly
5) Compression fractures

Answer 1

The fetus of a 25-year-old woman at 20 weeks gestation with preterm premature rupture of membranes is at greatest risk for pulmonary hypoplasia. This condition can result from a lack of amniotic fluid that normally helps the fetal lungs to expand and develop properly.

Step-by-step explanation:

The 25-year-old G2P1 woman at 20 weeks gestation who has been diagnosed with preterm premature rupture of membranes (PPROM) is at greatest risk for her fetus developing pulmonary hypoplasia. When the amniotic sac, which holds the fetus, ruptures too early, the reduction of protective fluid can lead to improper lung development because the fetal lungs may not expand properly. This risk is exacerbated by the fact that her last pregnancy also involved a preterm rupture of membranes, which could suggest an underlying issue that predisposes her to PPROM.

Low birth weight, preterm birth, and IUGR are additional concerns, as they can lead to significant health problems, including an increased risk of mortality shortly after birth. Moreover, the risk is higher the earlier the gestation at which the baby is born. After the 26-week point, the chances of survival are much higher if the baby receives the necessary medical care.