Salfelder A, Kagerah M, Nugent W, Hickl E J
Frauenklinik Finkenau, Hamburg.
Geburtshilfe Frauenheilkd. 1992 Dec;52(12):730-3. doi: 10.1055/s-2007-1023802.
Diagnosis of premature rupture of membranes (PROM) usually leads to severe clinical consequences. Diagnostic tests for confirmation of suspected rupture of membranes are either unreliable or can adversely affect the pregnancy. Foetal fibronectin is synthesised by the foetoplacental membranes especially in the anchoring villus. Its concentration in the amniotic fluid is 5-10 times greater, than in the maternal plasma. An immunoassay has recently been developed, which detects fibronectin in vaginal secretions using monoclonal antibodies, thereby establishing the presence of amniotic fluid in the vagina. Vaginal specimens were collected from 133 pregnancies. 34 of 35 patients with clearly visible amniotic fluid in the vagina had a positive test result (97.1%), whereas the majority of the control group without any signs of ruptured membranes had negative test results (96.5%). 39 of 41 women with positive test results delivered within 48 hours (95%). A positive test result thus helps to confirm the diagnosis of PROM especially in equivocal cases or may indicate forthcoming labour.
胎膜早破(PROM)的诊断通常会导致严重的临床后果。用于确认疑似胎膜破裂的诊断测试要么不可靠,要么会对妊娠产生不利影响。胎儿纤连蛋白由胎儿胎盘膜合成,特别是在固定绒毛中。其在羊水中的浓度比母体血浆中高5至10倍。最近开发了一种免疫测定法,使用单克隆抗体检测阴道分泌物中的纤连蛋白,从而确定阴道中是否存在羊水。从133例妊娠中采集了阴道标本。35例阴道内明显可见羊水的患者中有34例检测结果为阳性(97.1%),而大多数无胎膜破裂迹象的对照组检测结果为阴性(96.5%)。41例检测结果为阳性的女性中有39例在48小时内分娩(95%)。因此,阳性检测结果有助于确诊胎膜早破,尤其是在疑似病例中,或者可能预示即将分娩。