title: Silent premature rupture of membranes, detected and monitored serially by an AFP kit.
abstract: A 24-year-old woman underwent conization and cervical cerclage during pregnancy. After she later complained of fluid leakage, a premature rupture of the membranes (PROM) was suspected, because of positive results on a test for nitrazine, the intra-amniotic dye injection method (PSP test), and an AFP-kit test at 22 weeks of gestation. The nitrazine and PSP tests later turned negative. However, during the period from the 22nd through 26th weeks of gestation, the results of AFP-kit tests fluctuated, with repeated positive indications for bacterial cultures and elevated granulocyte elastase activity in the cervical mucus. The pregnancy was well maintained with administration of antibiotics and ritodrine hydrochloride until 34 weeks of gestation. The presence of chorioamnionitis, local inflammation of the fetal membranes, was found by pathological examination after the delivery. We propose a new clinical entity--to be referred to as silent PROM--the premature chemical rupture of the membranes.
authors.affiliation: Department of Obstetrics and Gynecology, Hokkaido University School of Medicine, Sapporo, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Yamada
authors.forename: T
authors.initials: T
authors.lastname: Kishida
authors.forename: H
authors.initials: H
authors.lastname: Negishi
authors.forename: T
authors.initials: T
authors.lastname: Sagawa
authors.forename: S
authors.initials: S
authors.lastname: Fujimoto
mesh_terms: D000328:Adult; D000649:Amniocentesis; D000653:Amniotic Fluid / Q000737:chemistry*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001391:Azo Compounds; D002278:Carcinoma in Situ / Q000175:diagnosis; D002584:Cervix Uteri / Q000601:surgery; D002821:Chorioamnionitis / Q000150:complications / Q000188:drug therapy / Q000473:pathology; D019092:Conization; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D006801:Humans; D007124:Immunoenzyme Techniques; D007202:Indicators and Reagents; D008297:Male; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000175:diagnosis; D011256:Pregnancy Outcome; D011933:Reagent Kits, Diagnostic; D012312:Ritodrine / Q000627:therapeutic use; D015149:Tocolytic Agents / Q000627:therapeutic use; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis; D000509:alpha-Fetoproteins / Q000032:analysis*
chemical_list: D000900:Anti-Bacterial Agents; D001391:Azo Compounds; D007202:Indicators and Reagents; D011933:Reagent Kits, Diagnostic; D015149:Tocolytic Agents; D000509:alpha-Fetoproteins; C013617:nitrazine yellow; D012312:Ritodrine