Outcomes following intra-amniotic instillation with indigo carmine to diagnose prelabor rupture of membranes in singleton pregnancies: a single center experience |
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Authors: | Henry Adekola Navleen Gill Sharif Sakr Deslyn Hobson David Bryant Jacques S. Abramowicz |
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Affiliation: | 1. Division of Maternal–Fetal Medicine, Hutzel Women's Hospital, Detroit Medical Center, Wayne State University, Detroit, MI, USA, hadekola@med.wayne.edu;3. Department of Obstetrics and Gynecology, Hutzel Women's Hospital, Detroit Medical Center, Wayne State University, Detroit, MI, USA, and;4. Division of Maternal–Fetal Medicine, Hutzel Women's Hospital, Detroit Medical Center, Wayne State University, Detroit, MI, USA, |
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Abstract: | Objective: To evaluate clinical outcomes of women with singleton pregnancies that underwent intra-amniotic dye instillation (amniodye test) following equivocal diagnosis of prelabor rupture of membranes (PROM).Method: Records of 34 pregnant women who underwent amniodye test for equivocal PROM were reviewed. Comparisons of characteristics, amniotic fluid (AF) cultures, AF interleukin (IL)-6 concentrations, and placenta pathology results between women who tested positive and those who tested negative were performed. A sub-analysis of women who were amniodye test-negative was also performed.Results: (1) Commonest indication for amniodye test was a typical history of PROM with positive conventional tests and persistently normal AF volume, (2) amniodye test-positive women had a shorter procedure-to-delivery interval (p?=?0.008), and a greater proportion of histologic acute chorioamnionitis (p?=?0.04) and funisitis (p?=?0.01) than amniodye-negative women, and (3) in addition to similarities to women with amniodye-positive test, amniodye test-negative women who delivered <34 weeks, had a greater proportion of women with risk for preterm birth (p?=?0.04), than their counterparts who delivered between 34 0/7 and 36 6/7 weeks.Conclusion: Equivocal diagnosis of PPROM should warrant an amniodye test to avoid iatrogenic intervention in women with intact amniotic membranes. AF analysis should be performed in amniodye test-negative women. |
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Keywords: | Amniodye test amniotic fluid culture amniotic fluid interleukin-6 concentration conventional tests placental pathology |
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