Back to Basics: Is that Amniotic Fluid?

Mon, 07/10/2017 - 5:00am
Author: 
Nicole Mansfield, MD
Editor: 
Alexis Pelletier-Bui, MD
Catherine Ginty, MD

Case:  A pregnant female presents with "damp" underwear upon wakening.  She has a history of intermittent urinary incontinence, however she is concerned for spontaenous rupture of membranes (amniorrhexis).

How to evaluate if vaginal fluid contains amniotic fluid:

 

  1. Sterile speculum exam

  • No lubricating jelly (affects pH)

  • Is there fluid pooling in posterior fornix or flowing from os?

 

  1. Nitrazine paper

  • Collect sample and apply to Nitrazine paper

  • Turns BLUE in the presence of alkaline amniotic fluid

 

  1. Ferning

  • Collect sample and apply to clean dry glass slide

  • Allow 10 minutes to fully dry

  • Ferning is a positive sign of amniotic fluid