National Institute for Health and Clinical Excellence (NICE)
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Device to diagnose pregnancy complications could help avoid use of speculum

A new device that detects the cause of unexplained vaginal wetness in pregnancy could help pregnant women avoid receiving unnecessary invasive speculum examinations, according to NICE.

Unexplained vaginal wetness during pregnancy can be caused by preterm, prelabour rupture of the membranes. This affects between 64,000 and 170,000 pregnant women each year, and occurs when the amniotic sac breaks before labour begins, leading to the leaking of amniotic fluid.

This can potentially lead to infection occurring, increasing the chance of further illness or even death for the baby.

However, unexplained vaginal wetness can also simply be leaking urine, which is not a cause for immediate concern.

NICE says GPs, midwives and practice nurses can use Vision Amniotic Leak Detector as a way of reliably excluding a leak of amniotic fluid as a cause of vaginal wetness in pregnancy.

The device is a diagnostic panty liner that can be attached to underwear, which has a central polymer-embedded strip that turns blue-green on contact with amniotic fluid.

This indicator strip contains reagents that react differently depending on the pH and whether ammonia is present, and should be won for up to 12 hours. The indicator strip is then removed and placed in the drying unit for 30 minutes.

If the indicator strip is yellow after drying, then the leak is unlikely to be amniotic fluid and so can avoid examination via speculum - a procedure that many women would prefer to avoid.

NICE says that when issued by a midwife or healthcare worker in a general practice setting, the device could save up to £24 per women through avoiding the need for referral to an antenatal day care unit.

Professor Carole Longson, Director of the Centre for Health Technology Evaluation at NICE, said: "This new guidance on use of the Vision ALD is good news both for pregnant women who experience unexplained vaginal wetness and for the NHS.

"The evidence considered shows that the device can reliably distinguish whether unexplained vaginal wetness in pregnancy is due to amniotic fluid leaking, or if it's due to urine which is less of a concern."

She added: "The guidance recommends that midwives and other healthcare professionals provide the Vision ALD to pregnant women experiencing this complication.

"This avoids the need for the woman to have an unnecessary speculum examination which is invasive and often uncomfortable."

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