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Re: ... (pH testing and ferning)From: mob@mbox301.swipnet.seWed Oct 20 18:26:23 1999
Different kinds of pH tests have about the same sensitivity for ROM as ferning (80-85%). Ferning is not directly related to pH so combining them should add to the accuracy. Fibronectin tests are very sensitive but there are too many false positives in the the last moth of pregnancy (leakage through intact membranes) - lots of papers on fibronectin lately but they're mostly about predicting premature deliveries. Insulin-like growth factor alpha tests are very sensitive and specific (except with heavy blood contamination). But there is at least one study showing no difference in the outcome (perinatal morbidity) between true late pregnancy episodes (positive tests) of "subclinical" leakage of amnionic fluid and other events where there is suspicion of leakage but with negative tests - a Swedish study in which they blinded the test results. Mats Bergstrom, MD Ob Gyn South Hospital Stockholm
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