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Test Code ROM ROM-RUPTURE OF FETAL MEMBRANE; AMNISURE

Aliasis

ROM

Patient Preparation

This test does not require a speculum exam

Special Collection Instructions

Kits are supplied by the laboratory

Collection Method

1. Open the AmniSure test kit and remove the contents
2. Shake the solvent vial to make sure that all of the liquid in the vial settles to the bottom.
3. Open the solvent vial and place it in a vertical position.
4. Insert the sterile polyester swab from the AmniSure test kit into the vagina for 2-3 inches. Withdraw the swab after a mininum of 15 seconds.
5. Place the polyester swab tip into the vial, break off excess part of swab and send specimen to the lab. (ASAP)
6. Properly identify the solvent vial by labeling the specimen with patients name (Pathnet label). Provide the date, time and collector intials on the label.

Container

AmniSure ROM kit

Preferred Specimen

AmniSure ROM kit

Acceptable Specimen(s)

AmniSure ROM kit

Reference or Target Ranges

Positive / Negative

Reportable Units

Positive / Negative

Critical Value

Not defined for this assay

Reasons for Rejection

Other:                

Presence of significant blood, collected with the swab, can lead to false postitive results.

QNS, Contamination, Improperly labeled, Improper specimen type

Specimen Stability

The sample must be tested within 30 minutes of collection.

Performance Information

Days and Time Performed

24/7

Expected Turn Around Time

Stat: 1 Hour, Routine: 4 Hours

Stat Availability

Yes

Performing Bench

CRMC Chemistry

Additional Information / Important Notes

False negative results may occur when the sample is taken more than 12 hours after the fetal membrane rupture has occurred.

Methodology/Method Description

AmniSure

CPT Codes

84112