Diagnosis of premature rupture of membranes in pregnant women with isthmic-cervical insufficiency using the IGFBP-1 PROM rapid test

• Vitaliy F. Bezhenar
• Fatima R. Kuchukova
• Zukhra K. Uzdenova

Abstract

The efficacy evaluation of the IGFBP-1 PROM rapid test was perfomed in 157 pregnant women with symptoms and signs of premature rupture of membranes. The results obtained showed that the IGFBP-1 immunoassay has high sensitivity and specificity.

The aim of the research was to diagnose premature rupture of fetal membranes in pregnant women with an obstetric pessary or cerclage using the IGFBP-1 PROM rapid test in case of suspected leakage of amniotic fluid.

Material and methods. The study included 157 women with singleton pregnancies at high risk of preterm delivery due to isthmic-cervical insufficiency (cervical length ≤25 mm and/or cervical infundibulum) or a history of preterm delivery.

Results. The rapid test is an accurate bedside test for diagnosing premature rupture of fetal membranes in women with threatened preterm labor. It has a sensitivity of 97.6%, a specificity of 93.1%, a positive predictive value of 98.4%, a negative predictive value of 90.0% and an overall accuracy of 96.8% in diagnosing premature rupture of fetal membranes.

Conclusion. IGFBP-1 immunoassay is an immunologic rapid test for the diagnosis of premature rupture of fetal membranes with high sensitivity and specificity.

Keywords:isthmic-cervical insufficiency; obstetrical pessary; cerclage, premature rupture of membranes; insulin-like growth factor-binding protein 1

REFERENCES

1. Obstetrics and gynecology. Clinical recommendations. 4th ed., revision and additions. In: V.N. Serov, G.T. Sukhikh (eds). Moscow: GEOTAR-Media, 2014. (in Russian)

2. ACOG Practice Bulletin No. 127: Management of preterm labor. American College of Obstetricians and Gynecologists; Committee on Practice Bulletins – Obstetrics. Obstet Gynecol. 2012; 119 (6): 1308–17.

3. Guidelines Premature Rupture of Membranes. In: Alabama Perinatal Excellence Collaborative (APEC). 2013. Protocol 9. Ver. 3. URL: www.apecguidelines.org/wp-content/uploads/2016/07/Premature-Rupture-of-Membranes-6-30-2015.pdf

4. Preterm prelabour rupture of the membranes. Guideline No. 24. In: Institute of Obstetricians and Gynaecologists, Royal College of Physicians of Ireland and Directorate of Strategy and Clinical Care, Health Service Executive. 2013. Ver. 1.0. URL: www.hse.ie/eng/about/Who/clinical/natclinprog/obsandgynaeprogramme/pretermrupture.pdf

5. Tavassoli F., Ghasemi M., Mohamadzade A., Sharifian J. Survey of pregnancy outcome in preterm premature rupture of membranes with amniotic fluid index < 5 and ≥ 5. Oman Med J. 2010; 25 (2): 118–23.

6. Frenette P., Dodds L., Armson B.A., Jangaard K. Preterm prelabour rupture of membranes: effect of latency on neonatal and maternal outcomes. J Obstet Gynaecol Can. 2013; 35 (8): 710–7.

7. Blanchon L., Accoceberry M., Belville C., Delabaere A., Prat C., Lemery D., et al. Rupture des membranes: physiopathologie, diagnostic, conséquences et prise en charge. J Gynecol Obstet Biol Reprod. 2013; 42: 105–16.

8. Szmulewicz C., Neveu M.E., Vigoureux S., Fernandez H., Capmas P. Emergency vaginal cervico-isthmic cerclage. J Gynecol Obstet Hum Reprod. 2019; 48 (6): 391–4. DOI: https://doi.org/10.1016/j. jogoh.2019.03.023

9. Nasyrova S.F., Ziganshin A.M., Vdovina T.R. Om method of diagnosing the state of the cervix in patients with post-traumatic disorders. Sovremennye problemy nauki i obrazovaniya [Modern Problems of Science and Education]. 2015; (6): 237. (in Russian)

10. Berghella V., Ciardulli A., Rust O.A., et al. Cerclage for sonographic short cervix in singleton gestations without prior spontaneous preterm birth: systematic review and meta-analysis of randomized controlled trials using individual patient-level data. Ultrasound Obstet Gynecol. 2017; 50 (5): 569–77.

11. Arabin B., Alfirevic Z., Cervical pessaries for prevention of spontaneous preterm birth: past, present and future. Ultrasound Obstet Gynecol. 2013; 42 (4): 390–9.

12. Barinov S.V., Shamina I.V., et al. Experience in the use of obstetric pessary Dr Arabin in the management of pregnant women at high risk for the development of preterm labour. Mat’ i ditya v Kuzbasse [Mother and Child in Kuzbass]. 2016; 1 (64): 38–41. (in Russian)

13. Liang D.Q., Qi H.B., Xiao S.C., Jia S.Y. Comparative study of placental alpha microglobulin-1 test, insulin-like growth factor binding protein-1 test and nitrazine test in the diagnosis of premature rupture of fetal membranes: a randomised controlled trial. J Obstet Gynaecol Res. 2014; 40 (6): 1555–60. DOI: https://doi.org/10.1111/jog.12381

14. Wang T., Zhou R., Xiong W., Wang V., Zhu C., Song C. Clinical evaluation of soluble intercellular adhesion molecule-1 and insulin like growth factor-binding protein-1-based rapid immunoassays the diagnosis of prelabor rupture of membranes. J Perinat Med. 2013; 41: 181–5.

All articles in our journal are distributed under the Creative Commons Attribution 4.0 International License (CC BY 4.0 license)