[Diagnosis of rupture of fetal membranes: comparison of vaginal detection of fetal fibronectin and intra-amnion injection of indigo carmine].
Amniotic fluid contains a heavily glycosylated pregnancy-related isoform of fibronectin (fFN), which can be detected using FDC-6, a monoclonal antibody directed against a novel epitope specific to fFN. It has been identified in the amniotic fluid in various concentrations throughout the different pregnancy periods and is localised at the interface of the chorion and the uterine decidua. Because of the unique pregnancy-associated expression of fFN, we determined the utility of cervicovaginal appearance of fFN as a marker of membrane integrity or rupture of membranes. In a prospective study we compared 1) the detection of fFN in cervicovaginal samples by a membrane-immunoassay (ROM-Check, Mast Diagnostica, Reinfeld, FRG) with 2) the results of intraamniotic injection of Indigo Carmine (IC), followed by the observation of dye spill into the vagina to confirm rupture of membranes. 65 patients were examined, 12 patients had to be excluded from the study for various reasons. Examination results were identical in 50 patients, while in three cases the fFN results were positive with a simultaneous negative result of the intraamniotic dye injection. In the case of blood contamination, the fFN test results were not valid; testing of maternal blood and of urine samples was fFN negative in all cases. We conclude, that oncofoetal fibronectin is an excellent marker for rupture of membranes. The test is easy to perform and does not involve the risk of an intraamniotic injection of dye.(ABSTRACT TRUNCATED AT 250 WORDS)
Beckmann
M W
MW
Abtl. Gynäkologie und Onkologie, Universitäts-Frauenklinik, Frankfurt.
Wiegratz
I
I
Dereser
M M
MM
Baier
P
P
Born
H J
HJ
D000650:Amnion; D000653:Amniotic Fluid / Q000737:chemistry*; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000175:diagnosis*; D005353:Fibronectins / Q000032:analysis*; D006801:Humans; D007203:Indigo Carmine; D007231:Infant, Newborn; D007267:Injections; D007752:Obstetric Labor, Premature / Q000175:diagnosis; D011247:Pregnancy; D011446:Prospective Studies; D012307:Risk Factors
D005353:Fibronectins; D007203:Indigo Carmine
Diagnostik des Blasensprungs: Vergleich des vaginalen Nachweises von fetalem Fibronectin und der intraamnialen Injektion von Indigo Carmine.