Prolactin Concentration in Vaginal Fluid: A New Method for Diagnosing Ruptured Membranes

Abstract

Prolactin concentrations were assayed in vaginal fluid, urine and plasma in 20 women between 38 and 41 weeks gestation. Plasma concentrations of 12.3 (7.3-20.8) mU/ml (n = 40) were found whereas urine concentrations were low or undetectable. Vaginal fluid concentrations were generally lower than 0 a25 mU/ml but occasionally elevated up to 3 mU/ml in women with unruptured membranes.Half an hour after artificial rupture of the membranes, vaginal fluid prolactin concentrations were always higher than paired maternal plasma concentrations (p < 0.001). In women suspected of premature rupture of the membranes, prolactin concentrations in vaginal fluid were always higher than the plasma concentrations except in those in whom the clinical outcome showed that the membranes had not ruptured. A rapid prolactin radioimmunoassay is therefore recommended as a new clinical tool for the diagnosis or exclusion of prematurely ruptured membranes.

The clinical significance of a positive Amnisure test™ in women with term labor with intact membranes

“…Several alternative tests—including alpha-fetoprotein10, insulin-like growth factor binding protein-111,12, fetal fibronectin,13 and prolactin14,15 have been suggested for the diagnosis of ROM. However, tests based on these analytes have not produced a satisfactory diagnostic performance.…”

Secretory endometrial and decidual proteins: studies and clinical significance of a maternally derived group of pregnancy-associated serum proteins

“…Clinical significance. The only clinical application of measurements of decidual prolactin has been in the diagnosis of prematurely ruptured fetal membranes (Koninckx et al, 1981;Healy, 1984). This application has been dependent upon the much higher concentrations of amniotic fluid prolactin compared with those in maternal blood, urine, or normal vaginal fluid, and enables diagnosis from 20 weeks' gestation.…”

Quel test biologique utiliser en cas de suspicion de rupture des membranes ?

“…D'autres marqueurs ont été évalués à partir de prélè-vements des sécrétions vaginales tels que la sous-unité bêta de l'hormone gonadotrophine-chorionique (hCG) [36,38,39], la prolactine (PRL) [36,40,41], l'urée [42], la créatinine [42,43], la thyroxine (T4) [44] et les lactates [45]. Le recueil des sécrétions vaginales était parfois précédé de l'instillation de quelques millilitres de sérum physiologique dans la cavité vaginale [39,41,44].…”