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IE20000630A1 - Assay to Detect Amniotic Fluid - Google Patents

Assay to Detect Amniotic Fluid

Info

Publication number
IE20000630A1
IE20000630A1 IE20000630A IE20000630A IE20000630A1 IE 20000630 A1 IE20000630 A1 IE 20000630A1 IE 20000630 A IE20000630 A IE 20000630A IE 20000630 A IE20000630 A IE 20000630A IE 20000630 A1 IE20000630 A1 IE 20000630A1
Authority
IE
Ireland
Prior art keywords
reagent
assay
amniotic fluid
sample
indicates
Prior art date
Application number
IE20000630A
Inventor
Hugh Graham
Original Assignee
Inverclyde Biolog
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Inverclyde Biolog filed Critical Inverclyde Biolog
Publication of IE20000630A1 publication Critical patent/IE20000630A1/en

Links

Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00Measuring for diagnostic purposes; Identification of persons
    • A61B5/145Measuring characteristics of blood in vivo, e.g. gas concentration or pH-value ; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid or cerebral tissue
    • A61B5/14507Measuring characteristics of blood in vivo, e.g. gas concentration or pH-value ; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid or cerebral tissue specially adapted for measuring characteristics of body fluids other than blood
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00Measuring for diagnostic purposes; Identification of persons
    • A61B5/43Detecting, measuring or recording for evaluating the reproductive systems
    • A61B5/4306Detecting, measuring or recording for evaluating the reproductive systems for evaluating the female reproductive systems, e.g. gynaecological evaluations
    • A61B5/4343Pregnancy and labour monitoring, e.g. for labour onset detection
    • GPHYSICS
    • G01MEASURING; TESTING
    • G01NINVESTIGATING OR ANALYSING MATERIALS BY DETERMINING THEIR CHEMICAL OR PHYSICAL PROPERTIES
    • G01N33/00Investigating or analysing materials by specific methods not covered by groups G01N1/00 - G01N31/00
    • G01N33/48Biological material, e.g. blood, urine; Haemocytometers
    • G01N33/50Chemical analysis of biological material, e.g. blood, urine; Testing involving biospecific ligand binding methods; Immunological testing
    • G01N33/52Use of compounds or compositions for colorimetric, spectrophotometric or fluorometric investigation, e.g. use of reagent paper and including single- and multilayer analytical elements
    • G01N33/521Single-layer analytical elements
    • GPHYSICS
    • G01MEASURING; TESTING
    • G01NINVESTIGATING OR ANALYSING MATERIALS BY DETERMINING THEIR CHEMICAL OR PHYSICAL PROPERTIES
    • G01N33/00Investigating or analysing materials by specific methods not covered by groups G01N1/00 - G01N31/00
    • G01N33/48Biological material, e.g. blood, urine; Haemocytometers
    • G01N33/50Chemical analysis of biological material, e.g. blood, urine; Testing involving biospecific ligand binding methods; Immunological testing
    • G01N33/84Chemical analysis of biological material, e.g. blood, urine; Testing involving biospecific ligand binding methods; Immunological testing involving inorganic compounds or pH
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B10/00Instruments for taking body samples for diagnostic purposes; Other methods or instruments for diagnosis, e.g. for vaccination diagnosis, sex determination or ovulation-period determination; Throat striking implements
    • A61B10/0045Devices for taking samples of body liquids
    • A61B10/0048Devices for taking samples of body liquids for taking amniotic fluid samples

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Molecular Biology (AREA)
  • Chemical & Material Sciences (AREA)
  • Immunology (AREA)
  • Physics & Mathematics (AREA)
  • Hematology (AREA)
  • Urology & Nephrology (AREA)
  • Pathology (AREA)
  • General Health & Medical Sciences (AREA)
  • General Physics & Mathematics (AREA)
  • Biophysics (AREA)
  • Animal Behavior & Ethology (AREA)
  • Medical Informatics (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Medicinal Chemistry (AREA)
  • Surgery (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Biotechnology (AREA)
  • Cell Biology (AREA)
  • Microbiology (AREA)
  • Biochemistry (AREA)
  • Analytical Chemistry (AREA)
  • Food Science & Technology (AREA)
  • Reproductive Health (AREA)
  • Pregnancy & Childbirth (AREA)
  • Gynecology & Obstetrics (AREA)
  • Optics & Photonics (AREA)
  • Inorganic Chemistry (AREA)
  • Investigating Or Analysing Biological Materials (AREA)

Abstract

An assay to detect amniotic fluid in a test sample, and hence to assist diagnosis of amniotic membrane rupture and of amniotic membrane rupture and of the onset of labour in a pregnant woman, is described. The test reagent used is bromthymol blue and a colour change to yellow indicates urine; to yellow/sea green indicates urine and/or vaginal secretions; to green or dark green indicates blood or amniotic fluid; and to blue indicates amniotic fluid. Desirably the reagent is used in liquid form, with the bromthymol blue being extracted with methanol and diluted with saline. A kit and a method of determining the rupture of amniotic membranes are also described.

Description

A commercially available kit, sold under the Trade Mark AMNICATOR relies upon the pH difference between amniotic fluid and that of urine, blood and vaginal secretions as detected by a dye based on nitrazine yellow. The AMNICATOR kit is produced in the form of cotton swabs impregnated with the nitrazine yellow dye and the instructions direct introduction of the swab into the vagina in an invasive procedure. The pH of the amniotic fluid is stated to be in the range of 7.0 to 7.5 whereas normal vaginal pH is 4.5 to 6.0. Additionally, invasive procedures are time-consuming to conduct and unpleasant for the patient to undergo.
It is an object of the present invention to provide an accurate assay to detect amniotic fluid. In a preferred embodiment the procedure does not rely upon invasive examination of a patient.
Additionally, our research into the field has noted that amniotic fluid does not have a pH between 7.0 to 7.5 as suggested by the literature accompanying the AMNICATOR assay, but instead has a minimum pH of from 8.1 to 8.5.
The present invention thus provides an assay to detect the presence of amniotic fluid in a test sample, said assay comprising: a) exposing the test sample to a reagent which contains the dye bromthymol blue as indicator; and b) noting any colour change and determining therefrom (for example by reference to a colour chart) whether or not amniotic fluid is present in the sample.
IE000630 In a preferred embodiment the reagent comprises bromthymol blue extracted with an alcohol, for example, methanol and optionally contains a quantity of water or saline as diluent.
Desirably the reagent comprises bromthymol blue, methanol, sodium chloride and water which may be desirably admixed in the proportions indicated below: Bromthymol Blue (Sultone form 3',3- Dibromothymolsulfonephthale in) 2 . Og Methanol 100.0ml Sodium chloride (NaCl) l.Og Water 900.0ml For convenience, the reagent will usually be supplied in liquid form and drops of the reagent may simply be spotted onto a sanitary towel or dressing previously worn by the patient and which has absorbed a sufficient quantity of the sample to be tested.
Alternatively, if necessary, a quantity of the reagent may be dropped onto DACRON™ swab which has been used to obtain a sample of the fluid by invasive techniques. This approach will usually only be adopted where internal examination of the patient is required for other purposes .
In a further aspect, the present invention provides a kit to detect the presence of amniotic fluid in a test sample, said kit comprising a reagent containing the dye bromthymol blue as indicator and a colour chart to aid interpretation of the results.
IE000630 In the colour chart, yellow indicates urine; yellow/sea green indicates urine and/or vaginal secretions; green or dark green indicates blood or amniotic fluid and blue indicates amniotic fluid.
Advantageously the kit contains full instructions for use and may optionally include swabs of synthetic fibres, for example DACRON™.
Additionally, positive and negative controls may be provided.
In a further aspect, the present invention provides a method of determining the rupture of amniotic membranes, said method comprising: 1) obtaining a sample of test fluid; 2) exposing said test fluid to a reagent which includes bromthymol blue as indicator; and 3) noting any colour change.
The assay will now be described in more detail.
Introduction The protocol set out here exemplifies the assay to detect presence of amniotic fluid as an aid to clinical judgement when a patient presents with Query Spontaneous Rupture of Membranes (denoted as ?SRM). The assay is rapid and simple involving a colour change and the interpretation of that colour change.
The assay differentiates between urine, vaginal secretions, blood and amniotic fluid.
IE000630 Test procedure: Speculum in place 1. If a speculum has been inserted into the vagina, a sample of any fluid should be taken with a sterile swab (supplied with the kit). Preferably a DACRON™ swab is used. 2. Withdraw the swab and add a drop of the reagent to the swab. 3. Observe the colour change. This will develop instantly.
Test procedure: Using the patient's sanitary towel 1. Using the dropper bottle, a drop of the reagent should be spotted to 3 or 4 different points across the towel. 2. Observe for colour change. This will develop instantly. 3. If necessary press the surface of the site of the drop to fully appreciate the developed colour.
Interpretation of developed colours 1. Yellow Not Amniotic Fluid Probably urine 2. Yellow/ Sea Green Not Amniotic Fluid Probably Urine or vaginal secretions 3. Mid/Dark Green Amniotic Fluid or blood* 4. Blue Amniotic Fluid * It is assumed that the user will observe any blood contamination on the swab or the towe-l and will abandon the assay if excess blood is present since this will mask the colour change of the reagent.
IE000630 The reagent is a non-hazardous fluid. It can be safely mopped up if accidentally spilled or flushed to waste.
The kit should be stored at ambient temperature in the box.
The following points should be noted to aid proper use of the assay: 1. Excessive urine on the towel or in the vagina may render the test invalid. 2. This test should only be considered as an aid to clinical judgement and any result obtained should not be considered diagnostic. 3. A towel soiled with amniotic fluid which has dried will still give a positive result. 4. Reagent which appears turbid should not be used.
. Reagent which appears other than red/orange should not be used. If it appears yellow, green or blue it should be discarded. 6. Only the swabs supplied with the kit should be used. Certain swabs are unsuitable and may provide an erroneous result. 7. Do not touch the swab or the patient's towel with the tip of the dropper. 8. Do not attempt to clean the tip of the dropper bottle with tap water. Wipe with a clean cloth and rinse using the reagent from the bottle. 9. A dry new towel will give a negative result (yellow).
. Contamination of a swab with 'AquaGel' or any other speculum lubricant may lead to a false positive result being recorded and care should be exercised by the user to avoid such contamination.
IE000630 Desirably the kit of the present invention contains the following: 1. Reagent; 2. Positive control; 3. Negative control; 4. Sterile swab sticks (for example 50 DACRON swabs); . Instructions for use; and 6. Colour guidance chart.
The box and bottles may carry a batch number and an expiry date .
Manufacture of the reagent and of the positive and negative controls is described in Example 1. ΙΕ000630 Example 1 The Reagent is prepared as follows: Bromthymol Blue (Sultone form 3',3Dibromothymolsulfonephthalein) 2 . Og Methanol 100.0ml Sodium chloride (NaCl) 1. Og Water 900.0ml 1. Accurately weigh the Bromthymol Blue and add to the methanol. 2. Allow to mix for at least 30 minutes and at least until the dye has completely dissolved. 3. Add this concentrate to the water. 4. Add the sodium chloride .
Mix thoroughly and filter to remove any remaining particles from the dye.
Adjust the pH using N/10 Sodium Hydroxide (NaOH) to 4.20 Quality Control PH Spec reading Conductivity 4.15-4.25 0.41-0.43 at 580nm 1.90-2.10mS at 22*C Water used must be very pure. Bottle in plastics bottles.
IE000630 1 2 3 4 The Positive Control is prepared as follows: di-Sodium Hydrogen Orthophosphate (Na2HPO4) 0.625g 5 Sodium di-Hydrogen Orthophosphate 0.338g 6 (NaH2PO42H2O) 7 Sodium Chloride (NaCl) 8.650g 8 Sodium Azide (NaN3) o.lg 9 Water to 1 litre 10 11 12 Adjust pH to 7.80 (lowest end of scale for a positive 13 result) using NaOH. 14 15 Quality Control 16 pH 7.75-7.85 17 Conductivity 14.00-17.OOmS at 22 °C 18 19 Bottle in 5ml glass dropper bottles. 20 21 The Negative Control is prepared as follows: 22 23 di-Sodium Hydrogen 0.625g 24 Orthophosphate (Na2HPO4) 25 Sodium di-Hydrogen 0.338g 26 Orthophosphate 27 (NaH2PO42H2O) 28 Sodium Chloride (NaCl) 8.650g 29 Sodium Azide (NaN.) O.lg 30 Water to 1 litre 31 32 IE000630 Adjust pH to 5.65 (Highest end of scale for a negative result) using HCl.
Quality Control pH 5.60-5.70 Conductivity 14.00-17.OOmS at 22’C Bottle in 5ml glass dropper bottles.
Swabs suitable for this assay are those made of synthetic fibre, for example of pure DACRON, which have been rendered sterile by irradiation or other means.
Example 2 The protocol outlined above was followed in 141 patients using the reagent of Example 1. The results are as follows: IE000630 Table % Correct Towels 98.5 % Correct Swabs 94.5 % correct 95.92 2 C & c -H S u & ω ω to ω ω H £V· >h CN r-l st< 440 4J O (D 4-) Ό >1 O 'Z (-I (D rH Q) d) 4-) 4-> b Μ (ΡΛ M m tn μ Λ! P ra ttlOOO^-HOO CD H4-)LUOr-l4-)U >-l CO CN 541 Towel 201 X3 Π5 s ω 363 Test Result Sea Dark Yellow Green Green Blue 164 203 45 152 Total Results to Date 564 IE000630 The results of the assay were verified by further examination of the patient to yield the accuracy figure of 95.92%.

Claims (3)

  1. Claims 1 An assay to detect the presence of amniotic fluid in a test sample, said assay comprising: a) exposing the test sample to a reagent which contains the dye bromthymol blue as indicator; and b) noting any colour change and determining therefrom whether or not amniotic fluid is present in the sample. 2 The assay as claimed in Claim 1 wherein a colour change of the reagent to blue indicates the presence of amniotic fluid in the sample and a colour change of the reagent to dark green indicates the presence of blood or amniotic fluid in the sample. 3 The assay as claimed in either one of Claims 1 and 2 wherein the reagent is used in liquid form. 4 The assay as claimed in any of Claims 1 to 3 wherein the reagent comprises bromthymol blue extracted with an alcohol. 5 The assay as claimed in Claim 4 wherein water or saline is used as a diluent in said reagent. 6 The assay as claimed in any one of Claims 1 to 5 wherein said reagent is applied to a portion of a dressing or sanitary towel previously worn by the patient and which has absorbed a sufficient quantity of the sample to be tested, and wherein the colour change of the reagent on said towel or IE000630 dressing is used to determine whether or not amniotic fluid is present. 7 The assay as claimed in any one of Claims 1 to 6 wherein a quantity of said reagent is applied to a swab previously used to obtain a test sample from the vagina of the patient, and wherein the colour change of the reagent on said swab is used to determine whether or not amniotic fluid is present. 8 A kit to detect the presence of amniotic fluid in a test sample, said kit comprising a reagent containing the dye bromthymol blue as indicator and a colour chart to aid interpretation of the results . 9 The kit as claimed in Claim 8 wherein the colour chart includes the following: blue - indicates amniotic fluid present; and green/dark green - indicates blood or amniotic fluid present 10 The kit as claimed in either one of Claims 8 and 9 wherein said reagent is in liquid form. 11 The kit as claimed in any one of the Claims 8 to 10 further comprising positive and negative controls. 12 The kit as claimed in any one of Claims 8 to 10 further comprising swabs of synthetic fibres. 13 A method of determining the rupture of amniotic IE000630 8 9 20 21 membranes, said method comprising: 1) obtaining a sample of test fluid;
  2. 2. ) exposing said test fluid to a reagent which includes bromthymol blue as indicator; and
  3. 3. ) noting any colour change. 14 The assay as claimed in Claim 13 wherein a colour change of the reagent to blue indicates the presence of amniotic fluid in the sample and a colour change of the reagent to dark green indicates the presence of blood or amniotic fluid in the sample. 15 The assay as claimed in either one of Claims 13 and 14 wherein the reagent is used in liquid form. 16 The assay as claimed in any one of Claims 13 to 15 wherein the reagent comprises bromthymol blue extracted with an alcohol. 17 The assay as claimed in any one of Claims 13 to 16 wherein water or saline is used as a diluent in said reagent.
IE20000630A 1999-08-14 2000-08-09 Assay to Detect Amniotic Fluid IE20000630A1 (en)

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
GBGB9919134.8A GB9919134D0 (en) 1999-08-14 1999-08-14 Assay

Publications (1)

Publication Number Publication Date
IE20000630A1 true IE20000630A1 (en) 2001-04-04

Family

ID=10859096

Family Applications (1)

Application Number Title Priority Date Filing Date
IE20000630A IE20000630A1 (en) 1999-08-14 2000-08-09 Assay to Detect Amniotic Fluid

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Country Link
GB (2) GB9919134D0 (en)
IE (1) IE20000630A1 (en)

Families Citing this family (9)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20070134740A1 (en) * 2005-12-12 2007-06-14 David Brusilovsky Compositions and articles for detection of analytes exceeding a pre-set threshold
WO2003007997A2 (en) * 2001-07-19 2003-01-30 Common Sense Ltd. Secretion-monitoring article
US7947467B2 (en) 2001-07-19 2011-05-24 Common Sense Ltd. Methods for monitoring pathological conditions in a female subject
US6627394B2 (en) * 2001-07-19 2003-09-30 Common Sense Ltd. Diagnostic pad
IL214096A (en) * 2011-07-14 2016-02-29 Gideon Mor System for detection of meconium in amniotic fluid
US9486368B2 (en) 2013-12-05 2016-11-08 Medline Industries, Inc. Disposable hygienic article with means for diagnostic testing
CN109613177B (en) 2014-07-01 2021-08-20 科蒙森斯公司 Diagnostic composition for identifying amniotic fluid
US11471335B2 (en) 2018-09-05 2022-10-18 University Of South Carolina Gel-within-gel wound dressing
US11698344B2 (en) 2018-09-05 2023-07-11 University Of South Carolina PH indicator swabs for biomonitoring and diagnostics

Family Cites Families (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4357945A (en) * 1981-06-01 1982-11-09 Janko Albert B Device for testing and rupturing amniotic membrane
JPH07108292B2 (en) * 1991-11-05 1995-11-22 白十字株式会社 Amniotic fluid rupture identification pad
US5738634A (en) * 1994-08-25 1998-04-14 Caillouette; James C. pH measurement of body fluid
US5425377A (en) * 1994-08-25 1995-06-20 Caillouette; James C. pH measurement of body fluid
AU7832598A (en) * 1997-07-11 1999-02-08 Lea T. Rosengreen Wearable amniotic fluid detection device
US6126597A (en) * 1998-07-22 2000-10-03 Smith; Ramada S. System for identifying premature rupture of membrane during pregnancy

Also Published As

Publication number Publication date
GB2353357A (en) 2001-02-21
GB9919134D0 (en) 1999-10-13
GB0019670D0 (en) 2000-09-27

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