ABSTRACT
This article evaluates the role of alpha-fetoprotein (AFP) testing in the diagnosis
of ruptured membranes in the preterm patient. AFP is normally found in amniotic fluid
and is not present in vaginal secretions. Testing for AFP in vaginal fluid was compared
with nitrazine evaluation and ferning in two groups of preterm patients, those with
intact membranes and those with ruptured membranes. There was no difference in the
sensitivities of AFP, nitrazine, or ferning in diagnosing ruptured membranes. The
specificities of AFP and ferning were similar and both were significantly better than
nitrazine. Duration of membrane rupture for greater than 24 hours negatively affected
the accuracy of all three tests. Blood-tinged amniotic fluid interfered with AFP and
nitrazine evaluation. AFP does not appear to offer a significant advantage over nitrazine
testing and ferning in the evaluation of patients with possible ruptured membranes.
