Use of insulin like growth factor binding protein-1 in the diagnosis of ruptured fetal membranes.
OBJECTIVE
The benefit of insulin like growth factor binding protein-1 (IGFBP-1) in diagnosing ruptured fetal membranes in cases in which the diagnosis is clinically doubtful, is investigated.


METHODS
A total of 83 patients with clinically doubtful rupture of fetal membranes were included, and treated as usual. The clinical diagnosis, the amniotic fluid crystallization test, and IGFBP-1 detection were performed on all patients and compared with the defined gold standard. The sensitivity, specificity, positive predictive value, and negative predictive value of each test were calculated.


RESULTS
In all, 27 patients (33%) had ruptured fetal membranes at the time of inclusion. The clinical diagnosis of the attending obstetrician showed a higher predictive value of both a positive and negative test result than both IGFBP-1 detection, and the amniotic fluid crystallization test.


CONCLUSIONS
As the clinical diagnosis showed the highest sensitivity and specificity, IGFBP-1 detection has no additional benefit to ascertain the diagnosis of ruptured fetal membranes in cases in which the diagnosis was clinically doubtful.
Jeurgens-Borst
Anneke J C M
AJ
Department of Gynecology/Obstetrics, Canisius Wilhelmina Hospital, Weg door Jonkerbos 100, 6532 SZ Nijmegen, The Netherlands. ajb@macobe.nl
Bekkers
Ruud L M
RL
Sporken
Jan M J
JM
van den Berg
Paul P
PP
D000328:Adult; D000653:Amniotic Fluid / Q000737:chemistry; D001826:Body Fluids / Q000737:chemistry; D003460:Crystallization; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000175:diagnosis*; D006801:Humans; D018970:Insulin-Like Growth Factor Binding Protein 1 / Q000032:analysis*; D011247:Pregnancy; D012680:Sensitivity and Specificity; D014621:Vagina
D018970:Insulin-Like Growth Factor Binding Protein 1