title: IGFBP-1 levels in cervicovaginal secretions before and after amniocentesis.
abstract: BACKGROUND
  To evaluate the levels of insulin-like growth factor-binding protein-1 (IGFBP-1) in cervicovaginal secretions before and after midtrimester amniocentesis and relate to clinical outcome.
  
  
  METHODS
  100 consecutive amniocentesis procedures were studied. We measured the IGFBP-1 concentration by radioimmunoassay in a cervicovaginal specimen before and after mid-trimester amniocentesis. The post-amniocentesis occurrence of vaginal loss of fluid or blood and abdominal pain was assessed by questionnaire.
  
  
  RESULTS
  In 6 cases there was a 100-fold increase in IGFBP-1 levels after amniocentesis. Loss of fluid per vaginam occurred in 4 (67%) of these pregnancies, compared to 3.2% of pregnancies without significant surge (p < 0.0001). In addition, post-procedural abdominal pain was more common among women with increased IGFBP-1 levels after amniocentesis (50 vs. 14%, p = 0.05). Two (33%) of the 6 patients with increased IGFBP-1 after amniocentesis delivered prior to 37 weeks as a result of spontaneous preterm labor and/or preterm ruptured membranes, compared to 7 (7%) in the group without surge in IGFBP-1 (p = 0.09).
  
  
  CONCLUSIONS
  Increased post-procedure IGFBP-1 levels are after mid-trimester amniocenteses are related to procedure-related complications like abdominal pain and subsequent amniotic fluid leakage.
authors.affiliation: Division of Obstetrics and Fetal Medicine, Department of Obstetrics and Gynecology, Katholieke Universiteit Leuven, Leuven, Belgium.
authors.forename: R
authors.initials: R
authors.lastname: Devlieger
authors.forename: J
authors.initials: J
authors.lastname: Verhaeghe
authors.forename: W
authors.initials: W
authors.lastname: Coopmans
authors.forename: J A
authors.initials: JA
authors.lastname: Deprest
mesh_terms: D000649:Amniocentesis / Q000379:methods*; D002584:Cervix Uteri / Q000378:metabolism*; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000175:diagnosis / Q000378:metabolism*; D006801:Humans; D018970:Insulin-Like Growth Factor Binding Protein 1 / Q000032:analysis / Q000378:metabolism*; D011247:Pregnancy
chemical_list: C032231:IGFBP1 protein, human; D018970:Insulin-Like Growth Factor Binding Protein 1