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  • Title: [Diagnosis of rupture of fetal membranes: CNGOF Preterm Premature Rupture of Membranes Guidelines].
    Author: Gallot D.
    Journal: Gynecol Obstet Fertil Senol; 2018 Dec; 46(12):1022-1028. PubMed ID: 30392990.
    Abstract:
    OBJECTIVE: To describe clinical and paraclinical tests diagnosing rupture of fetal membranes (ROM). METHODS: Bibliographic search over the period 1980-2017 considering articles in French and English as well as guidelines from national obstetrical societies. RESULTS: Typical amniotic fluid leakage occurs in ¾ of cases. In this situation, no additional test is required (Professional consensus). For ambiguous cases, a speculum examination can demonstrate pooling of amniotic fluid but suspicion can persist in 50% of cases (evidence level IV). In this context, we recommend to consider performing an IGFBP-1 or PAMG-1 test of vaginal fluid (evidence level III). Ability of these tests to reduce maternal or neonatal morbidity has never been demonstrated (Professional consensus). An isolated positive test should be considered cautiously as false positive does exist (Professional consensus). CONCLUSION: Symptoms suggestive of ROM and speculum examination demonstrating pooling of amniotic fluid are sufficient to diagnose ROM. If pooling is not observed, we recommend to consider performing an IGFBP-1 or PAMG-1 test of vaginal fluid.
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