| Premature rupture of membranes refers to spontaneous rupture of the amniotic sac with spill of amniotic fluid prior to onset of labor. History and physical will show loss of amniotic fluid from the vagina, and amniotic fluid may pool in the vagina on visual examination. Ultrasound is used to assess this situation, confirming oligohydramnios, or loss of fluid from the sac, while assessing the amount of residual amniotic fluid and the position of the fetus. Laboratory workup will reveal "ferning" of the vaginal fluid if amniotic fluid is present. The vaginal fluid will turn nitrazine paper blue in the presence of amniotic fluid. In order to detect infection, the fluid should be cultured. | | | | |