The premature rupture of (fetal) membranes occurs when the ...

PROM – The premature rupture of (fetal) membranes

occurs when the amniotic fluid membranes rupture, allowing amniotic fluid to be passed intothe vagina

The leakage may be slight with only a small amount of amniotic fluid seeping into the vagina, or it may be more dramatic with a gush.

Either way, it causes the pH within the vagina to rise, and this gives us a simple and practical way to detect the ruptured membranes.

Ruptured membranes are a significant hazard to the baby.

Intact membranes act as a barrier to the normal vaginal bacteria and microbial flora. With even a small rupture that defence is breached, and microbes can gain access to the baby, with resultant significant risk of infection.

Ruptured membranes can also trigger premature labour, presenting a significant risk to the baby.

Normal vaginal pH is 4.5 – 6.0

Normal vaginal pH is 4.5 – 6.0

Amniotic fluid has pH 7.1 –7.3

So presence of amniotic fluid (also called liquor) will cause pH to rise.

Amnicators are swabs with a bud

impregnated with nitrazine,

a pH indicator which changes

from yellow to blue above pH 6 5.0

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6.0

6.5

7.0

7.5

5.0

5.5

6.0

6.5

7.0

7.5

Like any simple method, if used carefully, Amnicators ® will provide accurate and useful information about the state of the amniotic membranes.

The method is self-contained, convenient and low cost and can prevent needless hospitalisation and clinical intervention.

So Amnicators® are a simple way to sample and assess whether rupture and ongoing leakage have really occurred.

5.0

5.5

6.0

6.5

7.0

7.5

Some substances with neutral or near neutral pH can also cause the Amnicator ®

bud to change colour.

Examples are:

Urine

Blood

Lubricant gel

Semen

It is essential to avoid touching any of these which could cause a false result. Please follow the recommended procedure carefully, as this will help to avoid any such false results.

5.0

5.5

6.0

6.5

7.0

7.5

Amnicators ® are very easy to use, but it is still important to understand how they should be used,

and how they work

So that results can be properly interpreted

For the benefit of both mother and baby.

Using Amnicators ®

1. The procedure is best performed with the mother lying on her back.

2. Cleanse the vulva and vagina introitus (vaginal opening)

Using Amnicators ®

1. The procedure is best performed with the mother lying on her back.

2. Cleanse the vulva and vagina introitus (vaginal opening)

3. Carefully insert a bi-valve speculum (eg Cusco's speculum) into the vagina and and open exposing the cervix.

Using Amnicators ®

1. The procedure is best performed with the mother lying on her back.

2. Cleanse the vulva and vagina introitus (vaginal opening)

3. Carefully insert a bi-valve speculum (eg Cusco's speculum) into the vagina and and open exposing the cervix.

4. Remove Amnicator® swab from peel pouch. Take care not to touch the tip, or allow it to come into contact with other substances.

Using Amnicators ®

1. The procedure is best performed with the mother lying on her back.

2. Cleanse the vulva and vagina introitus (vaginal opening)

3. Carefully insert a bi-valve speculum (eg Cusco's speculum) into the vagina and and open exposing the cervix.

4. Remove Amnicator® swab from peel pouch. Take care not to touch the tip, or allow it to come into contact with other substances.

5. Pass an Amnicator® into the vagina and sample for 15 seconds any liquor present at the external cervical os or in the posterior fornix of the vagina.

Using Amnicators ®

1. The procedure is best performed with the mother lying on her back.

2. Cleanse the vulva and vagina introitus (vaginal opening)

3. Carefully insert a bi-valve speculum (eg Cusco's speculum) into the vagina and and open exposing the cervix.

4. Remove Amnicator® swab from peel pouch. Take care not to touch the tip, or allow it to come into contact with other substances.

5. Pass an Amnicator® into the vagina and sample for 15 seconds any liquor present at the external cervical os or in the posterior fornix of the vagina.

OR

Using Amnicators ®

1. The procedure is best performed with the mother lying on her back.

2. Cleanse the vulva and vagina introitus (vaginal opening)

3. Carefully insert a bi-valve speculum (eg Cusco's speculum) into the vagina and and open exposing the cervix.

4. Remove Amnicator® swab from peel pouch. Take care not to touch the tip, or allow it to come into contact with other substances.

5. Pass an Amnicator® into the vagina and sample for 15 seconds any liquor present at the external cervical os or in the posterior fornix of the vagina.

6. Withdraw the Amnicator® and inspect the colour of the swab tip after 5 seconds.

7. Compare the colour of the Amnicator® with the table.

5.0

5.5

6.0

6.5

7.0

7.5

Using Amnicators ®

1. The procedure is best performed with the mother lying on her back.

2. Cleanse the vulva and vagina introitus (vaginal opening)

3. Carefully insert a bi-valve speculum (eg Cusco's speculum) into the vagina and and open exposing the cervix.

4. Remove Amnicator® swab from peel pouch. Take care not to touch the tip, or allow it to come into contact with other substances.

5. Pass an Amnicator® into the vagina and sample for 15 seconds any liquor present at the external cervical os or in the posterior fornix of the vagina.

6. Withdraw the Amnicator® and inspect the colour of the swab tip after 5 seconds.

7. Compare the colour of the Amnicator® with the table.

5.0

5.5

6.0

6.5

7.0

7.5

Intact

Possible rupture

Using Amnicators ®

1. The procedure is best performed with the mother lying on her back.

2. Cleanse the vulva and vagina introitus (vaginal opening)

3. Carefully insert a bi-valve speculum (eg Cusco's speculum) into the vagina and and open exposing the cervix.

4. Remove Amnicator® swab from peel pouch. Take care not to touch the tip, or allow it to come into contact with other substances.

5. Pass an Amnicator® into the vagina and sample for 15 seconds any liquor present at the external cervical os or in the posterior fornix of the vagina.

6. Withdraw the Amnicator® and inspect the colour of the swab tip after 5 seconds.

7. Compare the colour of the Amnicator® with the table.

5.0

5.5

6.0

6.5

7.0

7.5

Intact

Possible rupture

Further investigation may be required

Thank you for using Amnicators.