North American Registry of Midwives (NARM) Practice Exam

With premature rupture of membranes and a temperature of 100.4 F or greater, a presumptive diagnosis of what condition is made?

1. Placental abruption

2. Chorioamnionitis

3. Gestational diabetes

4. Preterm labor

The correct answer is: Chorioamnionitis

A temperature of 100.4°F or greater in the context of premature rupture of membranes (PROM) is indicative of infection in the intra-amniotic space. This condition is known as chorioamnionitis, an infection of the chorion and amniotic fluid, which can occur when the protective membranes surrounding the fetus rupture prematurely. When membranes rupture, the natural barrier against bacteria is compromised, increasing the risk for maternal and fetal infection. Symptoms such as fever in conjunction with PROM strongly suggest chorioamnionitis, necessitating prompt assessment and often treatment to prevent complications such as sepsis or preterm delivery. Other conditions like placental abruption, gestational diabetes, and preterm labor do not specifically correlate with the combination of PROM and elevated maternal temperature in the same manner. Thus, the presumptive diagnosis following these signs points definitively toward chorioamnionitis.