Management of preterm premature rupture of membranes: Assessing amniotic fluid in the vagina for phosphatidylglycerol

Maternal and Foetal Outcome in Premature Rupture of Membranes

“…7 PROM has been applied to rupture of the membranes at any time before the onset of labour irrespective of the duration of gestation 8 . PROM was defined as rupture of membranes prior' to the establishment of regular uterine contractions.…”

Comparison of vaginal and transabdominal collection of amniotic fluid for fetal lung maturity tests

“…They concluded that only the PG determination in vaginally collected amniotic fluid was useful as they found in samples from the vaginal pool higher L/S ratio's and more often PI than in samples from the amniotic sac. Determination of PG was thought to be a good test also in vaginally collected amniotic fluid because PG is found in no other body fluid than in lung surfactant [6]. However, vaginal bacterial flora appeared to be able to produce PG [7,8].…”

Phosphatidylglycerol determination in the amniotic fluid from a PAD placed over the vulva: a method for diagnosis of fetal lung maturity in cases of premature ruptured membranes

“…Some authors have collected the amniotic fluid by aspiration directly from the posterior vaginal fornix, but this procedure is unconfortable for the patient, does not always ensure that enough amniotic fluid is recovered, and may add to the risk of ascending infection resulting from the procedure [16,26]. Other authors [3] have proposed that amniotic fluid be collected by allowing it to flow freely from the vagina into an adequately prepared container, with the patient seated.…”

“…This problem was attributed to the oligohydramnios usually present in cases of PROM, and has been described by other authors [6,32]. As a result of the difficulty encountered in obtaining amniotic fluid via amniocentesis, from 1980, various investigators have studied amniotic fluid collected from the vagina [1,3,7,15,16,17,21,23,26,27,30,31]. The most reliable indicator of fetal lung maturity in amniotic fluid recovered from the vagina, is the presence of phosphatidylglycerol (PhG) [3,26,31].…”

“…As a result of the difficulty encountered in obtaining amniotic fluid via amniocentesis, from 1980, various investigators have studied amniotic fluid collected from the vagina [1,3,7,15,16,17,21,23,26,27,30,31]. The most reliable indicator of fetal lung maturity in amniotic fluid recovered from the vagina, is the presence of phosphatidylglycerol (PhG) [3,26,31]. In part, this is because the analysis of PhG is not altered by contamination of amniotic fluid by blood, meconium or seminal fluid [22,31] as occurs with other diagnostic methods such as the lecithin/sphingomyelin ratio and microviscosimetry [4,5,7].…”