Prediction of fetal pulmonary maturity from amniotic fluid obtained from the vagina after premature rupture of the membranes: A patient treated with dexamethasone

Isherwood, D. M.; McMurray, Jennifer A.; Campbell, Candace; Jenkins, David

doi:10.3109/00016348109154116

Cited by 3 publications

(1 citation statement)

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“…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].…”

Section: Introductionmentioning

confidence: 90%

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

Estol

Poseiro²,

Schwarcz³

1992

Jpme

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Four hundred and forty seven pregnant women with ruptured membranes, were prospectively studied in order to assess the diagnostic capacity of Phosphatidylglycerol (PhG) determination in amniotic fluid recovered from vulval pads in the diagnosis of Hyaline Membrane Disease (HMD). The identification of PhG was performed using one dimensional silica gel thin layer chromatography. The sensitivity of PhG determination in the diagnosis of HMD in newborns of the total population was found to be 88.2%, with a specificity of 76.9%. In the study population, the incidence of HMD was 7.6%, the negative predictive value was 98.8% and, the positive predictive value was 24.0%. When the 265 newborns of the gestational age group of less than or equal to 34 weeks is considered, we observed an incidence of HMD of 12.1%. The diagnostic capacity of PhG in this group was shown by a sensitivity of 87.5%, a specificity of 76.4%, a positive predictive value of 33.7% and a negative predictive value of 97.8%. This method of assessment of fetal lung maturity has a diagnostic capability similar to that described by other authors, who used amniotic fluid obtained vaginally or transabdominally. The procedure described here of amniotic fluid collection is non-invasive, harmless to the mother and fetus and simple to perform. The characteristics of this method, allow serial studies of the amniotic fluid to be carried out.

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Section: Introductionmentioning

confidence: 90%

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

Estol

Poseiro²,

Schwarcz³

1992

Jpme

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Preterm rupture of the membranes.

Drife¹

1982

BMJ

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Preterm rupture of the membranesIn between 6% and 12% of pregnancies' the fetal membranes rupture spontaneously before labour begins-a condition still (rather unsatisfactorily) called "premature" rupture of the membranes. If the pregnancy is at term labour usually follows or is induced with oxytocin to avoid possible infection. In about 2-3% of pregnancies, however, the membranes rupture before 37 weeks' gestation.2 This condition is best called "preterm" rupture of the membranes1 3: it occurs in around one-third of all preterm deliveries,2 and its management raises difficult questions.Usually no cause can be found, but a few cases are due to trauma, hydramnios, or cervical incompetence.4 Normally the tensile strength of the membranes is higher in midpregnancy than at term5 6: some investigators5 have reported an abnormally low collagen content in membranes that rupture spontaneously before term, but others6 have found no such abnormality and suggest that the rupture is due to localised weakness. Infection might be a cause,7 since amnionitis is more frequent4 when the membranes rupture just before labour than when they rupture just after its onset,4 and because preterm rupture of the membranes is more common8 when there is vaginal colonisation with group B streptococci.Diagnosis9 is usually based on the history, the results of examination with a sterile speculum (not digitally), and possibly testing the pool of liquid in the vagina with nitrazine. Urinary incontinence may be distinguished by giving the woman oral phenazopyridine to stain the urine. In the few cases'0 in which the diagnosis is still not clear staining of the amniotic fluid by amniocentesis has been suggested,9 10 but the risks include adverse effects of dye on the fetus," and most obstetricians would prefer to avoid this investigation.Management presents the two problems of avoiding infection and minimising the risks of prematurity. A recent study in Oxford showed bacterial colonisation in 41% of neonates after preterm rupture of the membranes, compared with 28% after premature rupture of the membranes at term and 23% of term infants after elective amniotomy.2 Bacterial colonisation correlated poorly, however, with chorioamnionitis.

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Preterm Rupture of the Membranes

Drife¹

2018

Prenatal Assessment of Multiple Pregnancy

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bone structure is directly related to the stresses imposed on bone.1 Later he proposed that all changes in the function of bones are attended by definite alterations in their internal architecture.2 This became known as Wolff's law-a law which can be restated in more general terms as: "The law of use and disuse." Use leads to hypertrophy, and disuse leads to atrophy.Bone mass and bone metabolism are relatively easy to measure, and Wolff's law as applied to bone has been repeatedly verified. It has been shown that both the action of gravity and the

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Prediction of fetal pulmonary maturity from amniotic fluid obtained from the vagina after premature rupture of the membranes: A patient treated with dexamethasone

Abstract: The case presented illustrates the potential of assessing fetal pulmonary maturity by analysing liquor draining vaginally after premature rupture of the membranes. The necessity of carrying out appropriate biochemical tests to detect contamination with maternal urine is emphasized.

Cited by 3 publications

References 9 publications

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

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

Preterm rupture of the membranes.

Preterm Rupture of the Membranes

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