The PROM tests segment has been categorized into nitrazine
test, ferning test, pooling, ultrasound, fetal fibronectin test, biomarker, and others.
(7) Traditionally, minimally invasive gold standard for diagnosis of PROM relies on clinician's ability to document three clinical signs on sterile speculum examination: 1) Visual pooling of clear fluid in the posterior fornix of the vagina or leakage of the fluid from the cervical os; 2) An alkaline pH of the cervicovaginal discharge, which is typically demonstrated by nitrazine
paper and/or 3) Microscopic ferning of the cervicovaginal discharge.
Strategies currently performed consist of sterile speculum examination and nitrazine
or fern tests , while ultrasound is useful to identify an AF reduction in the case of suspect membrane rupture .
The diagnosis of PPROM is made by obtaining a history of leaking amniotic fluid, clinical assessment, including speculum examination, and laboratory tests such as nitrazine
and fern tests.
CHICAGO -- The placental alpha-microglobulin-1 test is superior from a cost-benefit perspective to the combined traditional diagnostic test of pooling, nitrazine
, and ferning for screening in the setting of questionable preterm premature rupture of membranes, Dr.
The physical exam should be delayed until irrigation reaches an endpoint of neutral pH, as measured with Nitrazine
To verify the premature rupture of membranes in both groups, the speculum, fern, and nitrazine
tests were done.
I prepared the equipment I needed for the three part assessment (pooling, Nitrazine
This is important because a number of POC tests are not always recognized as "tests" by clinicians (eg, hemoccult, nitrazine
pH, provider-performed microscopy).
paper to assess the fluid collected from the posterior fornix for alkaline pH; this method has a positive predictive value (PPV) of 99% and negative predictive value (NPV) of 96%.
Nurse O'Connor performed a nitrazine
test and confirmed the presence of amniotic fluid, a sign that the patient could have had premature rupture of membranes.
Cooper tested the cervical-vaginal washings of 52 women: 24 of them had PPROM as confirmed by pooling of vaginal fluid and a positive nitrazine
strip test with ferning.