The value of the insulin-like growth factor binding protein-1 in the cervical–vaginal secretion detected by immunochromatographic dipstick test in the prediction of delivery in women with clinically unconfirmed preterm premature rupture of membranes

Akercan, Fuat; Çırpan, Teksin; Kazandı, Mert; Terek, Mustafa Coşan; Mgoyi, L; Özkinay, Erdinç

doi:10.1016/j.ejogrb.2004.12.006

Cited by 32 publications

(34 citation statements)

References 13 publications

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“…En la mayoría de los casos, el diagnóstico se realiza por el méto-do tradicional: presencia de líquido amniótico en el fondo de saco, arborización del líquido amniótico y prueba de nitrazina (1) Una técnica diagnóstica ideal debería ser aceptada tanto por las pacientes como por los médicos y debe ser apropiada, precisa y rápida. El uso de marcadores bioquímicos (AFP, diamino-oxidasa, prolactina o fibronectina fetal en el fluido vaginal) parecen ser métodos alternativos razonables para el diagnóstico de RPM (8,11). Estos marcadores tienen ventajas y desventajas.…”

Section: Discussionunclassified

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Gonadotropina coriónica en flujo vaginal para el diagnóstico de rotura prematura de membranas

Urdaneta-García¹,

Mejia-Montilla

Torres-Cepeda

et al. 2014

Rev. chil. obstet. ginecol.

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RESUMENObjetivo: Establecer la eficacia diagnóstica de la determinación de gonadotropina coriónica en flujo vaginal para el diagnóstico de la rotura prematura de membranas. Método: Investigación de tipo prospectiva en muestra de 270 embarazadas que asistieron al Hospital Central "Dr. Urquinaona", Maracaibo, Venezuela. Los grupos consistieron en pacientes con rotura prematura de membranas (grupo A; n = 135) y embarazadas con membranas integras (grupo B; n = 135), consideradas como controles. Se evaluaron las características generales, valores de gonadotropina coriónica en flujo vaginal y efectividad diagnóstica. Resultados: La edad gestacional al momento de la determinación de las concentraciones de gonadotropina coriónica en flujo vaginal fue de 32,9 ± 1,6 semanas para el grupo A y 33,1 ± 1,9 semanas para el grupo B (p = ns). No se encontraron diferencias estadísticamente significativas en la edad materna y la frecuencia de paridad entre ambos grupos de tratamiento (p = ns). Las pacientes del grupo A presentaron concentraciones significativamente más altas de gonadotropina coriónica en flujo vaginal (697,4 ± 382,4 mUI/mL) comparado con las embarazadas del grupo B (91,4 ± 47,1 mUI/mL; p < 0,0001). Un valor de corte de 100 mUI/mL presentó un valor por debajo de la curva de 0,96 con una sensibilidad del 97,0%, especificidad del 51,1%, valor predictivo positivo del 66,5% y valor predictivo negativo del 94,5%. Conclusión: La determinación de las concentraciones de gonadotropina coriónica en el flujo vaginal es una técnica diagnóstica útil para la rotura prematura de membranas.PALABRAS CLAVE: Gonadotropina coriónica, rotura prematura de membranas, líquido amniótico SUMMARY Objective: To establish the diagnostical efficacy of chorionic gonadotropin in vaginal fluid determination for diagnosis of premature rupture of membranes. Method: A prospective research type was done with a sample of 270 pregnant women who assisted to obstetrics emergency at Hospital Central "Dr. Urquinaona", Maracaibo, Venezuela. Groups consisted in patients with premature rupture of membranes (group A; n = 135) and pregnant women with intact membranes (group B; n = 135), considered as controls. General characteristics, values of chorionic gonadotropin in vaginal fluid and diagnostic efficacy were evaluated. Results: Gestational age at the moment of determination chorionic gonadotropin in vaginal fluid was 32.9 ± 1.6 weeks in group A and 33.1 ± 1.9 weeks in group B (p = ns). There were no significant differences in maternal age and frequency of parity between groups (p = ns). Patients in group A showed significant higher concentrations of chorionic gonadotropin in vaginal fluid (697.4 ± 382.4 mUI/mL) compared with pregnant women in group B (91.4 ± 47.1 mUI/mL; p < 0.0001). A cut-off point of 100 mUI/mL showed a under the curve value of 0.96 with a sensitivity of 97.0%, specificity of 51.1%, positive predictive value of 66.5% and

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Section: Discussionunclassified

“…Más aún, la liberación crónica de fibronectina previo al parto en embarazadas con membranas intactas puede llevar a resultados falso positivos (9,10). La IGFBP-1 tiene una sensibilidad de 74,4% y un valor predictivo negativo de 55,6% (11).…”

Section: Introductionunclassified

Gonadotropina coriónica en flujo vaginal para el diagnóstico de rotura prematura de membranas

Urdaneta-García¹,

Mejia-Montilla

Torres-Cepeda

et al. 2014

Rev. chil. obstet. ginecol.

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“…IGFBP-1 has a sensitivity of 87.5%, specificity of 94.4%, PPV of 92.1%, and NPV of 91.1% (13), although heavy vaginal bleeding and prolonged cessation of leakage might give false positive and negative results, respectively (14). Amnisure (PAMG-1 assay) is a bedside strip test with a sensitivity of 98.9%, specificity of 100%, a PPV of 100%, and an NPV of 99.1% (5), but its positive results should be interpreted cautiously, because the clinical significance of a positive test due to micro-leakage of amniotic fluid is not yet clear (15,16).…”

Section: Discussionmentioning

confidence: 99%

Diagnosis of Premature Rupture of Membranes by the Detection of Thyroid Hormones in Vaginal Secretions

et al. 2015

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Background: Premature rupture of membranes (PROM) and preterm PROM (PPROM) are the rupture of the fetal chorioamniotic membranes before the onset of labor contractions. Objectives: To evaluate whether detection of thyroid hormones in vaginal washouts can be used to diagnose premature rupture of membranes (PROM). Patients and Methods: Total T4 (thyroxin), total T3 (triiodothyronine), and free T4 concentrations in vaginal washouts were analyzed in 45 women with the diagnosis of PROM and compared with 45 normal pregnancies (controls). A Student's t-test was used for comparison of thyroid hormone values and a ROC curve was used for analyzing the diagnostic accuracy. Results: There were no differences between the patients with PROM and the control women regarding maternal age, gestational age, and parity. The mean concentration of total T4 in the PROM group and the control subjects were 2.1 ± 1.3 µg/mL and 1.55 ± 0.58 µg/, respectively (P = 0.01). Total T3 concentration in the PROM group was significantly higher compared to the controls (1.28 ± 0.42 ng/ vs. 0.8 ± 0.26 ng/, P < 0.0001). Also, free T4 concentration was significantly higher in the PROM group as compared with the controls (0.026 ± 0.034 ng/ vs.0.007 ± 0.004 ng/, P < 0.0001). The ROC curve analysis showed that total T4 = 1.685 µg/ had a sensitivity of 62%, specificity of 76%, positive predictive value (PPV) of 71.8%, and negative predictive value (NPV) of 66.7%. Total T3 = 0.82 ng/ gave a sensitivity of 91%, specificity of 64%, PPV of 72%, and NPV of 87.8%. Free T4 = 0.01 ng/ gave a sensitivity of 51%, specificity of 82%, PPV of 74.2%, and NPV of 62.7%. The best cutoff values were total T4 = 1.685 ng/, total T3 = 0.82 ng/, and free T4 = 0.01 ng/. Conclusions: Detecting total T4, total T3, and free T4 in vaginal washouts of patients suspected of PROM suspected is a simple, available, rapid, and inexpensive method for the diagnosis of PROM. However, a combination of three tests is recommended.

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“…In one study [1] , the IGFBP-1 test was compared with the results of DAO, a method that is not considered accurate in diagnosing ROM [45] , and in the other [21] , the performance metrics for the IGFBP-1 test were based on a heterogeneous outcome measure (delivery within 2 weeks) that does not allow for a direct association with ROM. It is noted that this study could have been eliminated from further evaluation during the second filter instead of the third because although the IGFBP-1 test used had a detection threshold matching that of the commercially available kit for IGFBP-1, the test was performed by placing the testing strip directly into the cervical os and posterior fornix of the vagina without the use of the collection swab [1] . Given that Rutanen et al [41] highlighted that the swab is responsible for a 1:16 dilution of the sample, the use of the test without the swab lowers the detection threshold of the test quite substantially.…”

Section: Study Selectionmentioning

confidence: 99%

The diagnosis of rupture of fetal membranes (ROM): a meta-analysis

Ramsauer

Vidaeff

Hösli

et al. 2012

Journal of Perinatal Medicine

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Aim: The aim of this study was to compare the performance of tests based on the detection of insulin-like growth factor binding protein 1 (IGFBP-1) and placental α -microglobulin-1 (PAMG-1) in diagnosing rupture of fetal membranes (ROM) across different patient populations. Methods: A meta-analysis was conducted on prospective observational or cohort studies investigating ROM tests based on the detection of IGFBP-1 and PAMG-1 meeting the following criteria: (1) performance metrics calculated by comparing results to an adequate reference method; (2) sensitivity thresholds of the investigated tests matching those of the currently available tests; (3) study population, as a minimum, included patients between 25 and 37 weeks of gestation. Sensitivities, specificities, and diagnostic odds ratios were calculated. Results: Across all patient populations, the analyzed performance measures of the PAMG-1 test were significantly superior compared with those of the IGFBP-1 test. Of particular clinical relevance, PAMG-1 outperformed IGFBP-1 in the equivocal group, which comprised patients with uncertain rupture of membranes (sensitivity, 96.0 % vs. 73.9 % ; specificity, 98.9 % vs. 77.8 % ; respectively). Conclusions: Compared with its performance in women with known membrane status, the accuracy of the IGFBP-1 test decreases significantly when used on patients whose membrane status is unknown. In this latter clinically relevant population, the PAMG-1 test has higher accuracy than the IGFBP-1 test.

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The value of the insulin-like growth factor binding protein-1 in the cervical–vaginal secretion detected by immunochromatographic dipstick test in the prediction of delivery in women with clinically unconfirmed preterm premature rupture of membranes

Cited by 32 publications

References 13 publications

Gonadotropina coriónica en flujo vaginal para el diagnóstico de rotura prematura de membranas

Gonadotropina coriónica en flujo vaginal para el diagnóstico de rotura prematura de membranas

Diagnosis of Premature Rupture of Membranes by the Detection of Thyroid Hormones in Vaginal Secretions

The diagnosis of rupture of fetal membranes (ROM): a meta-analysis

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