Diagnosis of PROM in pregnant patients who present with a history of leaking fluid

Some clinicians may choose to check the pH and arborization of a vaginal fluid sample themselves (ie, nitrazine and fern testing) rather than using a commercial test.
Criteria for AFV:

Oligohydramnios: AFI ≤5 cm, MVP <2 cm, or subjective impression.
Low normal AFV: AFI 6 or 7 cm or subjective impression.
Normal AFV: AFI >7 and ≤24 cm or subjective impression.
Polyhydramnios: AFI >24 cm, MVP ≥8 cm, or subjective impression.

PROM: prelabor rupture of membranes; AFV: amniotic fluid volume; AFI: amniotic fluid index; MVP: maximum vertical pocket.
* Refer to UpToDate topic on preterm prelabor rupture of membranes: Clinical manifestations and diagnosis. Other causes include urinary incontinence and vaginal discharge.

Graphic 121098 Version 3.0

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Diagnosis of PROM in pregnant patients who present with a history of leaking fluid