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AMCB Certified Nurse-Midwife - Blogs Sample Questions

Which of the following could be considered diagnostic of ROM (rupture of membranes)?

Correct Answer:
the observation of fluid coming from the cervical os


the rupture of membranes (rom) is a significant event during pregnancy, typically indicating that labor is imminent or has already begun. the amniotic sac, which holds the fetus and amniotic fluid, breaks either spontaneously or as a result of medical intervention. identifying rom is crucial as it can lead to labor or, if premature, require medical intervention to prevent infection or other complications.

among the options provided: 1. **lightening** - this refers to the baby dropping lower into the pelvis, preparing for birth, which usually occurs a few weeks before the onset of labor. although lightening indicates that the body is preparing for delivery, it is not specifically diagnostic of the rupture of membranes. 2. **the observation of fluid coming from the cervical os** - this is a direct sign of rom. when the amniotic sac ruptures, amniotic fluid escapes through the cervical opening (os). observing this fluid is a clear indication of membrane rupture. clinicians often confirm this through a visual examination and might use additional tests such as the nitrazine test (checking the ph of the fluid) or the fern test (microscopic examination of the fluid to see if it forms a fern-like pattern, indicative of amniotic fluid). 3. **infrequent contractions** - while contractions are a part of labor, their frequency and intensity can vary greatly and are not directly indicative of rom. infrequent or irregular contractions might suggest early labor or false labor (braxton hicks contractions) but are not diagnostic of membrane rupture. 4. **both b and c** - since option c (infrequent contractions) is not diagnostic of rom, this choice is also incorrect. the correct answer would be solely based on the observation of fluid coming from the cervical os, as noted in option b.

thus, the most accurate choice for diagnosing rupture of membranes from the options given is the observation of fluid coming from the cervical os. this observation directly indicates that the amniotic sac has ruptured, which is a definitive diagnostic sign of rom.