A nurse is reviewing the results of an AmniSure test on a client who has PROM at 36 weeks of gestation.
The test is positive for PAMG-1.
What does this result mean?
A.
The client has a high risk of developing preterm labor
B.
The client has a high risk of developing postpartum hemorrhage
C.
The client has confirmed membrane rupture
D.
The client has confirmed fetal lung maturity
The Correct Answer and Explanation is:
Correct Answer: C. The client has confirmed membrane rupture
Explanation:
The AmniSure test is a diagnostic tool used to detect the presence of placental alpha microglobulin-1 (PAMG-1) in vaginal secretions, which is a protein found in high concentrations in amniotic fluid. When the membranes surrounding the fetus rupture, amniotic fluid leaks into the vaginal canal, leading to the presence of PAMG-1 in the vaginal secretions. A positive result on the AmniSure test indicates that PAMG-1 is present, confirming that the membranes have ruptured.
Premature Rupture of Membranes (PROM) is a condition in which the amniotic sac ruptures before labor begins, and when it occurs before 37 weeks of gestation, it is referred to as preterm PROM (PPROM). PROM can lead to complications such as infection, umbilical cord prolapse, or placental abruption, which can endanger both the mother and the fetus. Confirming the diagnosis of PROM is crucial for the appropriate management of the pregnancy.
The AmniSure test is highly specific and sensitive for detecting ruptured membranes, with the presence of PAMG-1 being a strong indicator that the membranes have indeed ruptured. This test is preferred because it is non-invasive and provides rapid results, aiding in the timely decision-making process for managing PROM.
A positive AmniSure test result, indicating confirmed membrane rupture, necessitates close monitoring and management to prevent potential complications. The nurse should be aware of the increased risk of infection (chorioamnionitis) and should monitor the client for signs of labor, infection, and fetal distress. The healthcare provider may decide to initiate labor induction or administer corticosteroids to enhance fetal lung maturity, depending on the gestational age and other clinical factors.
Thus, a positive AmniSure test result means that the client has confirmed membrane rupture, aligning with answer C. The other options (A, B) relate to other obstetric risks but are not directly indicated by the AmniSure test result.