![]() ![]() Other methods such as those mentioned above are also dependent on successful sample collection 1, 10. After 48 hours of RPM latency, the nitrazine test and the fern test show 9.4% and 13-30% false negatives, respectively 7. They are limited by their number of false negatives and positives. Traditionally, pH-metry with nitrazine test and the fern test to visualize the characteristic 'fern-leaf' shape of sodium chloride in amniotic fluid have been used as diagnostic adjuncts in uncertain cases and have a sensitivity of 4281% 7, 8 ). Of the diagnostic laboratory studies, the gold standard for confirming PROM is to inject indigo carmine into the amniotic sac during amniocentesis and then evaluation for any blue fluid visibly leaking through the cervix or pooling in the vaginal vault, an invasive method not recommended for all patients 13. When a pool of amniotic fluid is not clearly seen, IGFBP1 or PAMG-1 testing should be considered, if available 12. ![]() The diagnosis of spontaneous rupture of the membranes is made by maternal history followed by sterile speculum examination demonstrating frank fluid in the cervical canal. The clinical picture is characterized by amniotic fluid leakage without contractions 1. PROM leads to maternal and fetal risks in approximately 8% of cases 7. Its etiology is multifactorial and can be affected by biochemical, physiological, pathological and environmental factors 5, 6. Its incidence is 10% of all pregnancies(3,4). Premature rupture of the ovular membranes (PROM) is defined as the loss of continuity of the chorioamniotic membrane before the onset of labor at term or preterm (PROM) before 37 weeks 1, 2.
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