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Specimen Collection Manual and Test Catalog

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RUPTURE OF FETAL MEMBRANES

Geisinger Epic Procedure Code:  LAB3029    Geisinger Epic ID:  36096

SPECIMEN COLLECTION
Specimen type: 

Vaginal swab


Preferred collection container: 
Specimen required: 

Extracted sample in collection vial.


Special notes: 

Remove the sterile swab from its package to collect a sample from the surface of the vagina. The tip of the swab should not touch anything prior to its insertion. Insert the swab tip into the vagina 2-3 inches (5-7cm) deep. Withdraw the swab after a minimum of 15 seconds. Place the swab tip into the vial and mix the swab in the buffer solution for at least 15 seconds. Break off the swab tip at the scored mark and leave the tip in the vial. Place the drop dispenser lid on the buffer vial and dispose of the remaining swab stick. Place the shipping cap back on the vial to transport to the lab so the specimen does not leak out. Please refer to ROM Plus Collection Instructions.



SPECIMEN PROCESSING
Processing instructions: 

Send immediately to the Stat Lab as prolonged storage is NOT recommended.


Transport temperature: 

Room temperature preferred. On ice acceptable.


Specimen stability: 

Stable for up to 6 hours at room temperature.


Rejection criteria: 

Stability limits exceeded. Moderately or grossly bloody specimens or specimen collected in the incorrect container.



TEST DETAILS
Reference interval: 

Negative.


CPT code(s):  84112
Note: The billing party has sole responsibility for CPT coding.  Any questions regarding coding should be directed to the payer being billed.
The CPT codes provided by GML are based on AMA guidelines and are for informational purposes only.

Test includes: 

Detection of AFP & IGFBP (PP12)


Methodology: 
Immunochromatography
Synonyms: 

ROM, PROM, PLACENTAL PROTEIN IMMUNOCHROM, PROM


Clinical significance: 

The test aids in the detection of rupture of membrane (ROM) in pregnant women when patients report signs, symptoms or complaints suggestive of ROM. A positive result is consistent with ROM.


Doctoral Director(s): 
Hoi-Ying Elsie Yu, PhD, DABCC, FADLM
Sheng-Ying (Margaret) Lo, PhD, DABCC
Benjamin Andress, PhD, DABCC
Review Date:  01/14/2025

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