Version July 2025
| Diagnostic tests (any of the following): |
| Physical examination that shows pooling of amniotic fluid in the posterior vaginal vault |
| Characteristic history supported by oligohydramnios on ultrasound examination |
| Positive commercial assay test (eg, AmniSure, Actim PROM, ROM Plus) |
| Positive nitrazine (pH) paper test and positive arborization (ferning) on glass slide |
| Assessments to consider after confirmation of membrane rupture: |
| Complete blood count |
| Rectovaginal culture for group B Streptococcus |
| Ultrasound examination for residual amniotic fluid volume; fetal growth, position, and anatomy; biophysical profile |
| Cardiotocography to monitor fetal heart rate (including a nonstress test) and frequency of uterine contractions |
| Testing for Neisseria gonorrhoeae, Chlamydia trachomatis, Trichomonas vaginalis, and bacterial vaginosis by standard methods |
