A dipstick test for infection in preterm premature rupture of the membranes.

Microbiological analysis of amniotic fluid obtained by amniocentesis is increasingly employed in preterm premature rupture of the membranes (PPROM) to predict those patients at increased risk of chorioamnionitis. Although liquor culture appears the most accurate predictor, a role exists for rapid but slightly less accurate testing. In this study, a dipstick (Cytur-test) which predicts the presence of leukocytes was evaluated in amniotic fluid. Twenty-one samples were obtained by amniocentesis from 25 women with PPROM at gestation 26-34 weeks. The dipstick predicted 5 out of 6 specimens with a positive culture and 12 of 14 with a negative culture (figure 1). Its accuracy as a predictor of a positive culture was similar to microscopy for polymorphs, with sensitivities of 83.3% and 80% respectively and specificities of 85.7% and 92.3%. Neither test proved as predictive of histological chorioamnionitis due to 6 patients delivering greater than 48 hours after amniocentesis who may have developed infection subsequent to the demonstration of sterile liquor.