OBJECTIVES: The objective of this study was to determine the most accurate method to use for the diagnosis of membrane rupture as well as to compare the sensitivity, specificity, positive and negative predictive values of such different methods.

METHODOLOGY: This prospective, non-randomized, descriptive study included 100 subjects, 50 each for the control group or women with intact membranes documented by history and physical examination, and gold standard group or women with ruptured membranes documented by history and pooling of amniotic fluid on speculum examination. Endocervical samples for control group (no pooling) and vaginal/posterior fornix samples for gold standard group (with pooling of fluid) were obtained from each patient used to test for determination using Actim^TM PROM test kit, ferning test, and pH testing using litmus paper.

RESULT: Ferning's test, Litmus paper test and Actim^TM PROM test have sensitivity of 30%, 44% and 74%, respectively specificity of 100%, 96%, 96% and respectively; PPV of 100%, 91.7% and 94.9% respectively; and NPV of 58.8%, 63.2% and 78.7% respectively. Actim PROM test kit was noted to be superior in terms of accuracy, followed by Litmus paper test, and lastly, by Ferning test as shown by the Receiver Operating Characteristic curve.

CONCLUSIONS: Actim^TM PROM test was noted to have the highest accuracy, as evidenced by the result of ROC curve, with the highest probability of testing positive in patients with true rupture of membranes, and with the highest Kappa statistic value or lowest probability of having interobserver variability.

Human ; Female ; Adult ; Fetal Membranes, Premature Rupture-diagnosis ; Preterm Premature Rupture of the Membranes

Premature prelabor rupture of membranes (PPROM) is defined as rupture of membranes before 37 completed weeks. The diagnosis of rupture of membranes can be made by using sterile speculum examination. Amniotic fluid is seen pooling in the posterior fornix or clear fluid is passing from the cervical canal. Presented is a case of PPROM which was managed with transabdominal amniotransfusion. The effects of amnioinfusion on pregnancy outcome in preterm premature rupture of membranes (PPROM) are unclear. Postulated benefits include prolongation of the latency period and prevention of pulmonary hypoplasia and infection. Transabdominal amnioinfusion is a promising procedure. It can be a very useful procedure in special cases, such as, preterm prelabor rupture of membrane to improve neonatal survival and outcome.

Human ; Female ; Adult ; Pregnancy ; Preterm Premature Rupture Of The Membranes ; Pregnancy Outcome ; Amniotic Fluid ; Fetal Membranes, Premature Rupture ; Delivery, Obstetric ; Vagina