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Test Code 300 Rupture of Membrane (ROM+) Test 

Important Note

The ROM+ is performed in the lab.

Additional Codes

ALAB: ROM+

PowerChart: Rupture of Membrane

MA Cerner: ROM Test 

Test Method

Immunochromatographic; ROM+ Clinical Innovations

Specimen Requirement

Vaginal secretions is required.

Additional Specimen Collection Information

Call the laboratory to notify them that a sample is being collected for a ROM+ test. 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 no more than 2-3 inches (5-7 cm) deep into the vagina.
  5. Withdraw the swab after a minimum of 15 seconds.
  6. Place the polyester tip of the swab into the buffer vial. Mix the swab in the buffer for 15 seconds.
  7. Lift swab 1 cm from the bottom of the vial. Bend the swab stick 90 degrees in the forward direction and then 180 degrees in the reverse direction. Leave the tip in the vial and dispose of the remaining swab stick.
  8. Place the shipping cap back on the buffer vial.
  9. Deliver the sample to the Laboratory.

Performance

Testing is performed Monday through Sunday.

Typically completed within 15 minutes after the specimen arrives at the testing site.

Reference Values

Detection of AFP and IGFBP-1 in vaginal secretions indicates the presence of amniotic fluid.

CPT Code Information

84112 Chemistry: Evaluation of cervicovaginal fluid for specific amniotic fluid protein(s) (eg, placental alpha microglobulin-1 [PAMG-1], placental protein 12 [PP12], alpha-fetoprotein), qualitative, each specimen.

Useful For

Detection of AFP (alpha feto-protein) and IGFBP-1 (insulin-like growth factor-binding protein-1 or PP12 (placental protein 12)) in vaginal secretions.

LOINC Code Information

IGFBP = 69945-4 and AFP = 19171-8