Test for ROM

  1. Anyone heard of this Indigo Carmine test for ROM? A blue dye is injected with NACL into the sac via amnioinfusion, and the pt is to wear a pad and report any blue discharge. How long with no blue is the test considered negative?

    Thanks!

    (You guessed it - this is what is happening with my friend with the twins)
    Last edit by RaeT,RN on Nov 5, '05
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  2. 11 Comments

  3. by   daisybaby
    I saw it done in the High Risk OB unit where I used to work. The blue dye was noted on her pads almost immediately. I can't remember her EDC, but do remember she delivered successfully several weeks later.

    I'm not sure if what length of time constitutes a negative ROM, though. I wish the best to your friend and her babies (I'm a twin)
  4. by   RaeT,RN
    That is good news, I think. She had the amnioinfusion on Wed, and here it is Sat and still no blue dishcharge, just the normal pregnancy stuff.

    As a further update, before the amnioinfusion she got a second opinion from another perinatologist in town, who (like her OB) does not agree that twin B is actually ruptured. Her MSAFP was elevated (she said the 'spinal part', not Down), so the two of them decided that maybe B had a bleed somewhere and was anemic, which would explain the oligo. I'm not sure how those two fit together. Anyways, they did a Kleihauer-Betke test and she is still waiting for the results of that.
  5. by   LizzyL&DRN
    How do you amnioinfuse someone if they aren't ruptured? Did they inject the dye via amniocentesis? Where I work we amnioinfuse through the IUPC catheter which you do not insert unless you are sure they're ruptured.
  6. by   babynurselsa
    I have seen it done with methylene blue. THis test goes way back. Not used too much I don't believe. My first encounter with it was walking into the NICU one night and as I passed a warmer saw this completely blue baby out of the corner of my eye. I nearly fell over myself getting over to the BS as the day nurse started giggling. She then explained it to me.
  7. by   RaeT,RN
    Amnioinfusion via amniocentesis (although I don't think you can call it an amniocentesis because they did not aspirate any fluid)
  8. by   SmilingBluEyes
    The term, "amniocentesis" is indeed appropriate, since literally, it only refers to the "puncture of the amnion" (amnio-centesis----amnion----punctured/breached). Medically-termed, this is correct.

    Please keep us updated, ok, Rae?
  9. by   dawngloves
    Wouldn't it be possible for leakage from the amnio site, thus providing a false positive?
  10. by   SmilingBluEyes
    I would think it is possible, Dawn.
  11. by   mugwump
    Actually where I work we do the "smurf" test quite frequently I would say a couple times a month. Granted we might do 4 in one week and none for another couple. Usually it is on a "ruptured" patient that has stopped leaking anything for a while, not wearing a pad etc... Usually even a normal or maybe low normal AFI. Amniocentesis is done, usually fluid asperated to check for infection sometimes sent for FLM and then the dye is added. The patient is then instructed to put in a tampon for 2-3 hours, sometimes they are allowed to ambulate depending on the situation if there is blue on the tip next to the cervix they are ruptured no blue they are not usually it is as simple as that.
  12. by   RaeT,RN
    She still has yet to leak any blue and it has been a week, so I am guessing that test was negative.

    She returned to her OB on Mon, and on ultrasound everything "looked good"; the fluid they had put in the sac was still there, and the baby and placenta looked fine. So now they don't know why there was oligo three weeks ago. Maybe she just had a high leak and it sealed back over??? The Kleihauer-Betke test was also negative. Her OB figures that if there is a problem somewhere, the baby will show it eventually - I mean there's got to be a reason for the oligo, they just don't know what it is yet.

    Very fascinating from a nursing standpoint. Frustrating for the mom and her husband, though. Still no definative answers.
  13. by   SmilingBluEyes
    bless their hearts. Thank you for the update.

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