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Positive fern test with amniotic fluid as seen under the microscope. The fern test is a medical laboratory test used in obstetrics and gynecology.The name refers to the detection of a characteristic "fern like" pattern of vaginal secretions when a specimen is allowed to dry on a glass slide and is viewed under a low-power microscope.
Amniotic fluid is composed of fetal cells, urine, and lung secretions. [46] 18-20 mL of amniotic fluid is slowly aspirated, with the first 1-2 mL typically discarded due to higher risk of maternal cell contamination. [2] The remaining sample is submitted for laboratory testing. [1]
One main test that is performed on amniotic fluid is the L/S ratio test (lecithin/sphingomyelin). This test is used to determine fetal lung maturity. Both lecithin and sphingomyelin are lung surfactants that are present in increasing amounts in the maturing fetus, though past week 33, sphingomyelin levels remain relatively constant.
An amniotic fluid sample is collected via amniocentesis and the sample is spun down in a centrifuge at 1000 rpm for 3–5 minutes. Thin layer chromatography (TLC) is performed on the supernatant, which separates out the components. Lecithin and sphingomyelin are relatively easy to identify on TLC and the predictive value of the test is good. [4]
Amniotic fluid index (AFI) is a quantitative estimate of amniotic fluid [1] and an indicator of fetal well-being. It is a separate measurement from the biophysical profile. [1] AFI is the score (expressed in centimetres) given to the amount of amniotic fluid seen on ultrasonography of a pregnant uterus.
Nitrazine paper test; Fern test; Amniotic fluid index; For results to be roughly 90% accurate in infection detection, a combination of both an arborization test and nitrazine paper test may be used. [11] An arborization test assesses the patient's vaginal secretions, while a nitrazone paper test uses the nitrazine paper to examines vaginal pH.
The AFP test is often done in the second trimester using the serum from the maternal blood draw. This test looks at a specific protein that is formed in the liver of the fetus and released into the fluid contents of the womb, which is then absorbed into the mother's blood stream. Multiple determinations stem from the results of AFP testing.
If the lack of amniotic fluid prevents accurate visualization on ultraosund, MRI imaging can be considered. Genetic testing can be useful if fetal anomalies are documented on imaging. An elevated maternal serum alpha fetal protein (MSAFP) can indicate leaking amniotic fluid due to damage to fetal membranes or the placenta. This is associated ...