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[Premature membrane rupture. Comparison of diagnostic tests]
S Trovò1, L Brigato, M Plebani
1Divisione Ostetrico-Ginecologia, Azienda Ospedaliera di Padova, ULSS 16.
Background:
Objective of this study was to evaluate the accuracy of the vaginal pH-test, the Fern-test, the research of foetal cells and of foetal fibronectin in vaginal discharge, which are used to diagnose premature rupture of membranes.
Methods:
To this aim 40 pregnant patients between 24th and 37th weeks gestation have been examined, considered at risk for sub-clinic loss of aminiotic fluid: 23 were affected by preterm labour and 17 by suspected rupture of membranes.
Results:
Subsequently amniotic sac was confirmed to be ripped in 10 cases (25%): 2 (8.7%) in the 23 patients with preterm labour, and 8 (47%) in the 17 patients with suspected PROM. Sensibility, specificity and accuracy were respectively: 70, 97 and 90% for pH-test; 70, 100 and 93% for Fern-test; 50, 93 and 82% for foetal cells; 100, 90 and 93% for fibronectin test.
Conclusions:
In personal experience fibronectin test appeared to be the most sensible and accurate marker. Fern-test was the most specific, while the research of foetal cells appeared to be the least reliable.