ABSTRACT
Objective: To evaluate the diagnostic potential of insulin-like growth factor binding protein-1 [IGFBP-1] in cervicovaginal secretions as an indicator of premature rupture of membranes [PROM] in comparison with the nitrazine test and amniotic fluid index [AFI]. The predictivity of these tests on the latency of pregnancy in patients with PROM was also studied
Design: Prospective controlled study
Setting: Department of Obstetrics and Gynaecology, Faculty of Medicine, Alexandria University
Subjects: 50 pregnant females [20 continued PROM, 20 suspected PROM and 10 with intact membranes acting as controls]
Interventions: Patients were subjected to sterile speculum examination, the nitrazine test, measurement of IGFBP-1 in cervicovaginal fluid by a rapid dipstick method [PROM test] and ultrasonographic assessment of AFI by the four quadrant method. All patients were followed up for one week to determine who went into spontaneous labour
Results: The mean gestational age did not differ significantly between groups. The sensitivity. Specificity, positive and negative predictive values of the nitrazine test, AF] and the PROM test in diagnosing PROM were 68.75%, 30%, 64.7%, 37.50% and 75%, 89%, 92.31%, 66.67% and 96.90%, 100%, 100%, 94.70%, respectively. Only a positive PROM test was associated with delivery within 1 week
Conclusion: The dipstick immunochromatographic method of detecting IGFBP-l in cervicovaginal fluid [PROM test] is a. rapid, reliable and non-invasive method in diagnosing PROM. It is the most accurate predictor of the latency of pregnancy in patients with suspected PROM