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Ferning of amniotic fluid contaminated with blood

R L Rosemond1, S J Lombardi, F H Boehm

  • 1Department of Obstetrics and Gynecology, Vanderbilt University Medical Center, Nashville, Tennessee.

Obstetrics and Gynecology
|March 1, 1990
PubMed

Insights

Diagnosing ruptured membranes using fern testing remains accurate even with blood contamination. While blood alters fern appearance, it does not compromise the test

Area of Science:

  • Obstetrics and Gynecology
  • Clinical Diagnostics
  • Reproductive Medicine

Background:

  • Traditional methods for diagnosing ruptured membranes, such as nitrazine paper and fern testing, report high accuracy rates (93-98%).
  • Conflicting literature exists regarding the impact of amniotic fluid contaminants on diagnostic accuracy.
  • The specific effect of blood contamination on fern testing accuracy requires clarification.

Purpose of the Study:

  • To investigate the influence of varying blood concentrations on the accuracy of fern testing for ruptured membranes.
  • To determine if blood acts as a contaminant that reduces the reliability of fern crystallization in diagnosing ruptured membranes.

Main Methods:

  • Amniotic fluid was collected from 38 patients (16-38 weeks gestational age) via amniocentesis.
  • Collected amniotic fluid was mixed with heparinized fetal cord blood at concentrations of 1:5, 1:10, and 1:20.
  • Microscopic examination was performed to assess the presence and morphology of ferning patterns.

Main Results:

  • All tested amniotic fluid samples exhibited positive ferning.
  • Atypical, "skeletonized" fern patterns were observed with increasing blood concentrations.
  • The number of atypical ferns increased significantly with higher blood-to-amniotic fluid ratios (32/38 at 1:5, 22/38 at 1:10, 9/38 at 1:20).

Conclusions:

  • Blood contamination can alter the morphology of fern patterns in amniotic fluid samples.
  • Despite morphological changes, blood does not appear to act as a contaminant that compromises the diagnostic accuracy of fern testing for ruptured membranes.

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