Rupture of membranes

Rupture of membranes (ROM) or amniorrhexis is a term used during

Rupture of membranes can affect ongoing labor management. Certain methods of labor induction or augmentation such as balloon catheters are relatively contraindicated after ROM.[7]

Types

• SROM: spontaneous rupture of membranes. This term describes the normal, spontaneous rupture of the membranes at
  full term. The rupture is usually at the bottom of the uterus, over the cervix, causing a gush of fluid. This gush may be quite small (such as 50ml), or it can be significantly large (200-300ml) depending upon amount of fluid in the amniotic sac, and to what extent the fetal head is plugging the hole and retaining fluid in the sac.^[8]
  A spontaneous rupture that occurs early in labor may actually be related to other complications resulting in delayed labor. These complications may include a contracted pelvis, breech presentation, or occipito-posterior position.
• PROM:
  premature rupture of membranes
  . This term describes a rupture of the membranes that occurs before the onset of labor.
  • PPROM: preterm, premature rupture of membranes. This term describes a rupture of the membranes that occurs before 37 weeks gestation, and it can have multiple effects on the fetus such as increasing their risk of prematurity and facing neonatal or perinatal complications. Risk factors of pregnancies with PPROM include race (
    multifetal pregnancy)), and tobacco smoking.^[9]
• AROM:
  obstetrician, in order to induce
  or accelerate labor.

Detection of rupture of membranes mainly include:[10]

• Pooling test: visualization of amniotic fluid pooling in the vagina
• Nitrazine paper test
• Fern test
• Amniotic fluid index

For results to be roughly 90% accurate in infection detection, a combination of both an arborization test and nitrazine paper test may be used.^[11] An arborization test assesses the patient's vaginal secretions, while a nitrazone paper test uses the nitrazine paper to examines vaginal pH.

References