How is premature rupture of membranes (PROM) diagnosed?

Updated: Oct 05, 2018
  • Author: Allahyar Jazayeri, MD, PhD, FACOG, DACOG, FSMFM; Chief Editor: Carl V Smith, MD  more...
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ROM is diagnosed by speculum vaginal examination of the cervix and vaginal cavity. Pooling of fluid in the vagina or leakage of fluid from the cervix, ferning of the dried fluid under microscopic examination, and alkalinity of the fluid as determined by Nitrazine paper confirm the diagnosis.

Blood contamination of the Nitrazine paper and ferning of cervical mucus may produce false-positive results. Pooling of fluid is by far the most accurate for diagnosis of ROM. If all fluid has leaked out as in early PROM, an ultrasonographic examination may then show absence of or very low amounts of amniotic fluid in the uterine cavity.

New evidence suggests that the use of biochemical markers to diagnose ROM in uncertain cases may be appropriate and cost effective. Echebiri et al reported cost effectiveness compared to standard methods of diagnoses between 34 and 37 weeks. [5]

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