title: Accurate Point-of-Care Detection of Ruptured Fetal Membranes: Improved Diagnostic Performance Characteristics with a Monoclonal/Polyclonal Immunoassay.
abstract: OBJECTIVE
  Accurate and timely diagnosis of rupture of membranes (ROM) is imperative to allow for gestational age-specific interventions. This study compared the diagnostic performance characteristics between two methods used for the detection of ROM as measured in the same patient.
  
  
  METHODS
  Vaginal secretions were evaluated using the conventional fern test as well as a point-of-care monoclonal/polyclonal immunoassay test (ROM Plus(®)) in 75 pregnant patients who presented to labor and delivery with complaints of leaking amniotic fluid. Both tests were compared to analytical confirmation of ROM using three external laboratory tests. Diagnostic performance characteristics were calculated including sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy.
  
  
  RESULTS
  Diagnostic performance characteristics uniformly favored ROM detection using the immunoassay test compared to the fern test: sensitivity (100% vs. 77.8%), specificity (94.8% vs. 79.3%), PPV (75% vs. 36.8%), NPV (100% vs. 95.8%), and accuracy (95.5% vs. 79.1%).
  
  
  CONCLUSIONS
  The point-of-care immunoassay test provides improved diagnostic accuracy for the detection of ROM compared to fern testing. It has the potential of improving patient management decisions, thereby minimizing serious complications and perinatal morbidity.
authors.affiliation: Memorial Healthcare Systems, Hollywood, FL, USA.
authors.forename: Linda C
authors.initials: LC
authors.lastname: Rogers
authors.affiliation: Memorial Healthcare Systems, Hollywood, FL, USA.
authors.forename: Laurie
authors.initials: L
authors.lastname: Scott
authors.affiliation: Independent Clinical Consultant, San Francisco, CA, USA.
authors.forename: Jon E
authors.initials: JE
authors.lastname: Block
keywords: ROM Plus®; alpha-fetoprotein; fern test; insulin-like growth factor binding protein-1; placental protein 12; point-of-care immunoassay; premature rupture of membranes