Nitrazine and Fern Tests for Rupture of Membranes


Sunquest Code:FERN  
Epic Code:LAB4194Epic Name:FERN AND NITRAZINE TEST POCT
Synonyms:Fern Crystallization; Rupture of Membranes (ROM)


Collection Instructions

Specimen:Fluid, cervical or amniotic
Optimal Volume:microscope slide swabbed with fluids
Collection Instructions:

 

a.        Place patient in right or left lateral position for 20-30 minutes to allow pooling of any amniotic fluid.

b.        Position patient in supine position with slight elevation of buttocks either by raising bed at hip level or by placing an inverted bed pan covered with a towel under the hips.

c.        Insert sterile speculum using sterile technique. DO NOT warm speculum or use any lubricant.

d.        Use spotlight or flashlight to view cervix and check for pooling of liquid.

e.        Swab area near the cervical OS using sterile Q-tip. If pooling liquid is present, saturate Q-tip with fluid. Avoid touching the vaginal wall and cervix.

f.         Collect specimen for nitrazine and fern tests. Spread the collected fluid that adheres to the swab over microscope slide and nitrazine paper. Apply a thin layer to the microscope slide for best results. Allow slide to air dry (do not apply coverslip). Only handle slide with gloves, as fingerprints may give false results or interfere with interpretation.

g.        Remove speculum. Reposition patient.

 



Processing and Shipping

Test Performed at or Referral Lab Hematology  (Fairview Ridges - FRH, Fairview Northland - FNMC, Fairview Southdale - FSH, Fairview Clinics)


Interpretive

Reference Range:

 

Nitrazine pH:

5.0-6.0

Probably membranes are not ruptured.

6.5-7.0

Probably membranes are ruptured.

7.5

May be due to blood or cervical mucus

 

Fern Crystallization:

Positive result

Fern pattern, i.e. palm leaf pattern is observed when amniotic fluid crystallizes as it dries on a glass surface. Observation of a fern pattern indicates the presence of amniotic fluid.

Negative result

Beaded or cellular appearance of cervical mucus.

 

 



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