PG gel makes delay of delivery less important in term infants with an unripe maternal cervix. Beta strep screening also may change management. Also test urine. We should discuss with our referral center in Green Bay as to whether they would like us to obtain a fluid sample and transport it with the patient. If do amniocentesis obtain cultures and Gram stain.
Digital examination precipitates labor and increases the risk of ascending infection.
This probably occurs because of disruption of the cervical mucous by the examining finger. C-SXN reserved for usual obstetrical indications, there is increased maternal risk if chorioamnionitis present. May do c-sxn however if suspect very virulent infection. Active labor is the most common indication for delivery. Tocolysis doesn't seem to work in PROM especially with a preterm infant.