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The Need For a More Accurate ROM Test

"Evaluation of ferning, nitrazine, and/or ultrasound has shown that they add little, if anything, to speculum examination alone and that none of them are as accurate as the test based on biochemical markers. Accordingly, we believe that there is little to merit their use in modern practice."

- Di Renzo GC, Cabero L, et al. "Guidelines for the management of spontaneous preterm labor." J Matern Fetal Neonatal Med 2011; 24(5): 659-667.

Traditional methods of ROM diagnosis date back to the 1940s and are either inaccurate, invasive, or both. Institution-specific factors such as type of facility, obstetric service provided, and personnel qualifications do not allow all practitioners to fulfill the traditional algorithm for confirming a PROM diagnosis.

traditional ROM tests comparison chart

  • de Haan HH, Offermans PM, Smits F, et al. Value of the fern test to confirm or reject the diagnosis of ruptured membranes in modest in nonlaboring women presenting with nonspecific vaginal fluid loss. Am J Perinatol 1994;11:46-50.
  • Jeurgens-Borst AJ, Bekkers RL, Sporken JM, van der Berg PP. Use of insulin like growth factor binding protein-1 in the diagnosis of ruptured fetal membranes. Eur J Obstet GynecolReprodBiol 2002;102:11–14.
  • Watanabe T, Minakami H, Itoi H, Sato I, Sakata Y, &Tamada T. Evaluation of Latex Agglutination Test for Alpha-Fetoprotein in Diagnosing Rupture of Fetal Membranes. Gyneco Obstet Invest 1995:39: 15-18.
  • Fujimoto S, Kishida T, Sagawa T, NegishiH,Okuyama K, HareyamaH,et al. Clinical usefulness of the dye-injection method for diagnosing premature rupture of the membranes inequivocal cases. J Obstet Gynaecol 1995;21(June (3)):215–20.
  • Birkenmaier A, Ries JJ, Kuhle J, Bürki N, Lapaire O, Hösli I. Placental α-microglobulin-1 to detect uncertain rupture of membranes in a European cohort of pregnancies. Arch Gynecol Obstet. 2012 Jan;285(1):21-5.


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