Comparative evaluation of test systems for determining premature rupture of membranes
https://doi.org/10.21518/ms2023-103
Abstract
Introduction. Preterm premature rupture of the membranes (PPROM) is one of the most common pregnancy complications. PPROM as а cause of infectious complications poses the greatest danger with increasing duration of period without amniotic fluid (i.e., watchful waiting) in full-term pregnancy.
Aim. Comparative evaluation of test systems for the diagnosis of premature rupture of the membranes (PROM) based on the determination of the pH of the vaginal contents, the detection of placental alpha macroglobulin-1 (PAMG) or insulin-like growth factor-binding protein 1 (IGFBP-1).
Materials and methods. The study included 52 patients at 22–41 weeks of gestation in whom, according to the clinical examination, it is impossible to exclude/confirm PROM. All women were examined for the detection of PROM using test systems: nitrazine pH test, immunochromatographic test for the detection of IGFBP-1 or PAMG-1. The sensitivity, specificity, accuracy, predictive value of positive and negative results were calculated.
Results. As a result of the study, premature rupture of the membranes was confirmed in 25 cases, and this diagnosis was excluded in 27 cases. In three observations, additional observation and examination were required due to the questionable interpretation of the result due to a test error. Sensitivity and specificity were 64.0 and 66.7% for the nitrazine test, 95.8 and 92.3% for IGFBP-1, and 95.8 and 96.3% for PAMG-1.
Conclusion. The nitrazine test has low sensitivity and specificity, therefore, for the diagnosis of PROM, test systems based on the determination of PAMG-1 and IGFBP-1 should be used, which improves the quality of diagnosis, reduces the risk of complications and ensures the timely start of a set of measures appropriate to the clinical situation. A negative test result avoids unnecessary hospitalization and unnecessary interventions, which is important both from a medical and economic point of view.
About the Authors
O. R. Baev
Kulakov National Medical Research Center of Obstetrics, Gynecology and Perinatology;
Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation
Russian Federation
Oleg R. Baev, Dr. Sci. (Med.), Professor, Head of the 1st Maternity Department, 4, Academician Oparin St., Moscow, 117997;
Professor of the Department of Obstetrics, Gynecology, Perinatology and Reproductology, Institute of Professional Education, 8, Bldg. 2, Trubetskaya St., Moscow, 119991
D. A. Babich
Kulakov National Medical Research Center of Obstetrics, Gynecology and Perinatology
Russian Federation
Russian Federation
Dmitriy A. Babich, Cand. Sci. (Med.), Obstetrician-Gynecologist of the 1st Maternity Department,
4, Academician Oparin St., Moscow, 117997
A. R. Gaydarova
Kulakov National Medical Research Center of Obstetrics, Gynecology and Perinatology
Russian Federation
Russian Federation
Asiyat R. Gaydarova, Postgraduate Student,
4, Academician Oparin St., Moscow, 117997
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Review
For citations:
Baev OR, Babich DA, Gaydarova AR. Comparative evaluation of test systems for determining premature rupture of membranes. Meditsinskiy sovet = Medical Council. 2023;(5):130-135. (In Russ.) https://doi.org/10.21518/ms2023-103
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