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Year : 2017  |  Volume : 34  |  Issue : 2  |  Page : 85-90

Diagnosis of foetal membrane ruptures: Placental alpha-microglobulin-1 to the rescue

Department of Obstetrics and Gynaecology, Lagos State University College of Medicine, Ikeja, Lagos, Nigeria

Correspondence Address:
Joy O Agbara
Department of Obstetrics and Gynaecology, Lagos State University, College of Medicine, No 1-5 Oba Akinjobi Road, G.R.A. Ikeja
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/TJOG.TJOG_57_16

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Context: Pre-labour rupture of membranes (PROM) is a common obstetric complication which presents a diagnostic challenge, especially in equivocal cases. Standard methods of diagnosis are limited by high false positives and negatives. This study compared the accuracy of a biomarker placental alpha microglobulin-1 (PAMG-1) with the traditional methods of diagnosis. Objective: To compare the accuracy of PAMG-1 in cervicovaginal secretions with other standard methods in the diagnosis of PROM. Materials and Methods: A longitudinal prospective study was conducted among women with symptoms and signs of PROM at the Lagos State University Teaching Hospital. Standard tests and PAMG-1 assay were compared with the reported final diagnosis at delivery. Descriptive analysis was done using the Statistical Package for Social Sciences (SPSS) version 19. Results: A total of 140 consenting pregnant women were recruited in the study. An initial diagnosis of PROM was made in 67 patients (47.9%) using the standard methods of diagnosis whereas PAMG-1 immunoassay using Amnisure ROM test diagnosed PROM in 86 patients (61.4%). Upon review of patients' clinical records, 88 women (62.8%) had a final diagnosis of PROM. In the final analysis, PAMG-1 assay had a sensitivity of 97.7%, specificity 100%, PPV 100% and NPV 96.7%. The standard methods had a sensitivity 76.1%, specificity 92.2%, PPV 90.1% and NPV 70.4%. PAMG-1 had a highest accuracy of 98.6%, followed by nitrazine test 89.3%, pooling of liquor 83.5% and fern test 51.4%. Conclusion: The immunoassay of PAMG-1 had a higher diagnostic accuracy and is recommended for the diagnosis of PROM.

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