ROM Rupture of [fetal] Membranes

Useful For

The ROM Plus (Rupture of [fetal] Membranes) Test is a rapid, non-instrumented qualitative immunochromatographic test for the in vitro detection of amniotic fluid in vaginal secretions of pregnant women. ROM Plus detects PP12 (also known as Insulin-like Growth Factor Binding Protein-1/IGFBP-1) and AFP (Alpha-fetoprotein) markers of amniotic fluid in vaginal secretions. The test is for use by health care professionals to aid in the detection of ROM in pregnant women when patients report signs, symptoms or complaints suggestive of ROM.


The timely and accurate diagnosis of rupture of fetal membranes (ROM) is crucial since the ROM may be associated with serious neonatal and maternal consequences. Failure to identify patients with ROM can result in the failure to intervene appropriately. Conversely, the false diagnosis of ROM can lead to inappropriate interventions (e.g., hospitalization or induction of labor). Therefore, the correct and timely diagnosis of ROM is of crucial importance for the clinician. Accurate diagnosis of fetal membranes rupture, however, remains a frequent clinical problem in obstetrics.

Method Name

Qualitative Immunochromatographic


ROM, PROM, Rupture Of Membranes, Premature Rupture Of Membranes, Rupture Of Fetal Membranes, Premature Rupture Of Fetal Membranes, Rupture Of Membranes

Specimen Type


Specimen Required

Vaginal swab collected and placed in the buffer vial.

Specimen Stability Information

• Vaginal swab collected and placed in the buffer vial.

• Specimen is stable for six (6) hours from time of collecting the vaginal swab sample and placing it into the buffer vial.

Special Instructions

– The ROM Plus Membranes Rupture Test is for the in vitro detection of human amniotic fluid PP12 and AFP proteins in vaginal secretions of pregnant women. The test should be used to evaluate patients with clinical signs/symptoms suggestive of fetal membranes

Order a ROM Test (Rupture of Fetal Membranes). Label the solvent vial appropriately with two identifiers, patient name and another identifier, (patient ID number, DOB, etc.) include date and time of collection and initial of person collecting the specimen.

  1. Collect sample of vaginal secretions using a sterile vaginal swab provided in the kit.
  2. Remove swab from packaging using care not to touch anything prior to insertion into vagina.
  3. Collect sample from surface of vagina, holding swab in the middle of the stick while patient is lying flat on back.
  4. Carefully insert the polyester tip of the swab into the vagina until fingers contact the skin no more than 2-3 inches (5-7 cm) deep.
  5. Withdraw the swab after 1 minute.
  6. Rinse swab after collection in solvent vial for 1 minute.
  7. Remove swab and dispose of in a biohazard container.
  8. Recap the vial and label the tube appropriately with patient name and two identifiers (patient ID number, DOB, etc.).
  9. Sample should be taken to the Lab within 30 minutes of collection.
  10. The patient sample will be tested as soon as possible after collection.
  11. If patient sample is not tested within 30 minutes, the sample may be stored refrigerated for up to 6 hours.

Performing Laboratory

As Ordered

Reference Values


Day(s) and Time(s) Performed

Sunday – Saturday

24 hours/day

CPT Code Information

84112 Chemistry: Evaluation of cervicovaginal fluid for specific amniotic fluid protein(s) (PAMG-1), each specimen