October 28, 2009,
L.B. asks from Granite City, IL on October 27, 2009
Postive Nitrazine Test and Negtive Fern Test Twice
I have been leaking extra fluid the last serval days and at my doc appt yesterday he did a nitrazine test that came back postive and the the fern test came back negtive so he sent me to ob to monitor for a while, get an utrla sound to check levels and then do another test in a couple of hours. My fluid was lower than two weeks ago and but still in safe levels but the tests did the same thing which bothered my doc because my last 3 pregnancys my water broke early and in a trickle so he wants to make sure that it is not amoniotic fluid I am 32 weeks and 3 days and have been on meds to stop contractions since 28 weeks and on light activity and not picking up my other children. Now he wants to do the blue dye tampon test where they put blue dye in the fluid and you where a tampon and if it comes out blue you are leaking. Has anyone had this and is it dangrous or painful in any way?
C.M. answers from St. Louis on October 27, 2009
I would ask your Dr about the AmniSure test
Here are some highlights I found:
The “gold standard” for diagnosis of PROM is amnio-dye infusion into the amniotic cavity with confirmation of
membrane rupture by detection of leakage of dye into the vagina (staining of a tampon) within 20 to 30 minutes. This technique is highly invasive and may be associated with risk to pregnancy including bleeding,
infection, iatrogenic rupture of membranes, and loss of pregnancy. (American Proficiency Institute – 2008 3rd Test Event EDUCATIONAL COMMENTARY – DETECTING PREMATURE RUPTURE OF FETAL MEMBRANES)
Currently the only FDA-approved immunoassay for detection of membrane rupture is the AmniSure ROM
test (AmniSure International LLC, Cambridge, MA), a one-step immunochromatographic assay using three
monoclonal antibodies for the detection of PAMG-1. The sample used is cervicovaginal secretion taken by sterile swab inserted 2 to 3 inches with no speculum
required. The specimen is eluted into a vial containing solvent, and the test strip is then placed in the vial for approximately 5 minutes. the presence of two lines (test and control) indicates rupture of membrane and one line (control zone only) indicates no rupture of membrane. Initial studies indicated 99% accuracy
(American Proficiency Institute – 2008 3rd Test Event_
I hope this helps you learn more about the different options out there. As a mother to a preemie born at 25 weeks I wish nothing but the best for you and your baby and hope you can go full term.
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S.D. answers from Topeka on October 27, 2009
I have never heard of the blue tampon test but if you are leaking fluid the strip will change color.I was alway's told if you notice any leaking wear a pad and if it's wet after an hr lying down on your left side call your doc or go get checked out on the L&D if it is amnoiotic fluid then induction will be started because you don't want to risk a dry birth nor get an infection before delivery.I have falsely went several times to get checked out I have 3 kid's but since my braxton hicks were so bad and frequent at times I thought it was labor till I actually go into labor.My bladder leaked fluid so bad while pregnant.good Luck your baby will be here soon
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C.M. answers from Kansas City on October 28, 2009
I just want to reassure you that you baby will be alright. If it is fluid that is leaking and you have to have that baby early, there are so many things that they can do now for premature babies. Yes, it is ALWAYS better to wait if you can but please don't stress about the baby because it will only make things worse. If you are really concerned that you will have this baby early, ask the doctors their oppinion about give you the drugs to help open up baby's lungs. If you make it to 34 weeks, there is no need for the drugs. If it looks like this little one will come before then, ask for the drugs. Either way, the baby will be ok.
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S.L. answers from Kansas City on October 28, 2009
I've never heard of this test so can't answer on that but I do know back when I had kids they never even did an internal exam until the end as it might cause things to progress,so they said back then. I would be very, very careful of having this done with your history and I know there are other ways to check the fluid and leakage. I had my first at 32 1/2 weeks and I would be so careful with putting a tampon in there. Check out these other two helpful replies you got and see if there isn't a much safer way to check all of this out.
A.C. answers from Kansas City on October 28, 2009
I have a few thoughts for you. I've been an OB nurse for 7 years and sometimes Nitrazine turns blue from sweat, urine, or blood. You can be ruptured and leak scant amounts of fluid over time. I've never heard of the dye/tampon test. You need to ask your physician exactly what that procedure entails. Sounds pretty invasive and not without risks I'm sure. Ask your doctor how common this test is. Amnisure is a great way to test for amniotic fluid. It's a matter of having access to it. Your physician clinic or hospital where you will be delivering may not routinely use it and therefore may not have it available. I would ask if there is anyway your physician could get it before doing the dye test. Hope this helps you. Good Luck!