The Ferning and Nitrazine Tests of Amniotic Fluid Between 12 and 41 Weeks Gestation

Bennett, Shirley L.; Cullen, J.; Sherer, David M.; Woods, James R.

doi:10.1097/00006254-199309000-00006

Cited by 8 publications

(12 citation statements)

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“…Ferning is unaffected by meconium at any concentration or changes in pH. Small amounts of blood were not found to affect ferning but blood and amniotic fluid mixed in equal amounts resulted in no ferning 3 . Amniotic fluid specimens were found to be fern and nitrazine positive, up to two weeks after amniocentesis.…”

Section: Diagnosis and Evaluationmentioning

confidence: 88%

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Preterm premature rupture of membranes: diagnosis, evaluation and management strategies

Simhan

Canavan

2005

BJOG

181

118

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Preterm premature rupture of the membranes (PPROM) is responsible for one-third of all preterm births and affects 120,000 pregnancies in the United States each year. Effective treatment relies on accurate diagnosis and is gestational age dependent. The diagnosis of PPROM is made by a combination of clinical suspicion, patient history and some simple tests. PPROM is associated with significant maternal and neonatal morbidity and mortality from infection, umbilical cord compression, placental abruption and preterm birth. Subclinical intrauterine infection has been implicated as a major aetiological factor in the pathogenesis and subsequent maternal and neonatal morbidity associated with PPROM. The frequency of positive cultures obtained by transabdominal amniocentesis at the time of presentation with PPROM in the absence of labour is 25 -40%. The majority of amniotic fluid infection in the setting of PPROM does not produce the signs and symptoms traditionally used as diagnostic criteria for clinical chorioamnionitis. Any evidence of infection by amniocentesis should be considered carefully as an indication for delivery. Documentation of amniotic fluid infection in women who present with PPROM enables us to triage our therapeutic decision making rationally. In PPROM, the optimal interval for delivery occurs when the risks of immaturity are outweighed by the risks of pregnancy prolongation (infection, abruption and cord accident). Lung maturity assessment may be a useful guide when planning delivery in the 32-to 34-week interval. A gestational age approach to therapy is important and should be adjusted for each hospital's neonatal intensive care unit. Antenatal antibiotics and corticosteroid therapies have clear benefits and should be offered to all women without contraindications. During conservative management, women should be monitored closely for placental abruption, infection, labour and a non-reassuring fetal status. Women with PPROM after 32 weeks of gestation should be considered for delivery, and after 34 weeks the benefits of delivery clearly outweigh the risks.

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Section: Diagnosis and Evaluationmentioning

confidence: 88%

“…The nitrazine test was found to be more susceptible to alteration by contamination. The presence of bacterial vaginosis (BV), cervicitis, semen, alkaline urine, blood, soap and antiseptic solutions was found to alter the nitrazine test, mainly resulting in a false positive 3,4 …”

Section: Diagnosis and Evaluationmentioning

confidence: 99%

Preterm premature rupture of membranes: diagnosis, evaluation and management strategies

Simhan

Canavan

2005

BJOG

181

118

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show abstract

“…The ferning test has been associated with false positive results in 5–30% of patients and false negative results in 5–12.9% of patients . The nitrazine test is easily contaminated by other fluids, such as semen, urine, blood, and antiseptic solution . PROM is an important dilemma in clinical practice, and we urgently require alternative, accurate and fast methods to help us solve the problem.…”

Section: Introductionmentioning

confidence: 99%

Comparative study of placental α‐microglobulin‐1, insulin‐like growth factor binding protein‐1 and nitrazine test to diagnose premature rupture of membranes: A randomized controlled trial

Liang

Luo

et al. 2014

J of Obstet and Gynaecol

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“…Regarding the necessity for accurate diagnosis of PPROM, several diagnostic tests have been suggested. Nitrazine test, fern test, and ultrasound have been considered as very useful tests . Biochemical tests have also been suggested, but should only be performed in cases of very suspicious ROM, which other simple tests may not diagnose accurately.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of vaginal fluid β‐human chorionic gonadotrophin for the diagnosis of preterm premature rupture of membranes

Bahasadri

Kashanian

Khalili

2013

J of Obstet and Gynaecol

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Aim: The purpose of the present study was to evaluate vaginal fluid b-human chorionic gonadotrophin (b-hCG) for the diagnosis of preterm premature rupture of membranes (PPROM). Material and Methods: An observational cross-sectional study was performed on 123 pregnant women who were in the third trimester of their gestation (28-37 weeks). The patients were divided into three groups: (i) PPROM group (41 cases); (ii) suspected PPROM group (42 cases); and (iii) intact membranes control group (40 cases). Five milliliters of sterile normal saline was inserted into the posterior fornix of the vagina and then vaginal fluid was aspirated and sent to the laboratory for b-hCG measurement. Finally, the amount of b-hCG was compared in the three groups. Results: b-hCG concentration was 7.71 Ϯ 15.7 mIU/mL in the intact membrane control group, 468.06 Ϯ 366.34 mIU/mL in the PPROM group and 176.43 Ϯ 316.37 mIU/mL in the suspected PPROM group, which showed a significant difference between the three groups (P < 0.001). In order to find an optimal cut-off value for b-hCG, the receiver-operator curve was used and a cut-off value of 79.5 mIU/mL with a sensitivity of 95% and specificity of 84% was determined to be optimal. Conclusion: b-hCG was higher in the cases of PPROM and patients who were suspected to have PPROM, and may be used as a suitable, fast and reliable test for detecting rupture of membranes.

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The Ferning and Nitrazine Tests of Amniotic Fluid Between 12 and 41 Weeks Gestation

Cited by 8 publications

References 0 publications

Preterm premature rupture of membranes: diagnosis, evaluation and management strategies

Preterm premature rupture of membranes: diagnosis, evaluation and management strategies

Comparative study of placental α‐microglobulin‐1, insulin‐like growth factor binding protein‐1 and nitrazine test to diagnose premature rupture of membranes: A randomized controlled trial

Evaluation of vaginal fluid β‐human chorionic gonadotrophin for the diagnosis of preterm premature rupture of membranes

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