Comparison between AmniSure placental alpha microglobulin-1 rapid immunoassay and standard diagnostic methods for detection of rupture of membranes.
Objective. To determine the diagnostic accuracy of placental alpha microglobulin-1 assay and standard diagnostic methods for detecting rupture of membrane. Study Design. Prospective diagnostic study, between June 2011 to November 2011 at a tertiary centre. Initial evaluation included both the standard diagnostic methods for rupture of membranes and placental alpha microglobulin-1 immunoassay. The actual rupture of membranes was diagnosed on review of the medical records after delivery (absence of membrane or a positive pad chart). Main Outcome Measures. Placental alpha microglobulin-1 immunoassay and standard diagnostic methods for diagnosis of rupture of membrane. Results. A total of 211 patients were recruited. At initial presentation, 187 patients (88.6%) had ruptured membranes, while 24 patients (11.4%) had intact membranes. Placental alpha microglobulin-1 immunoassay confirmed rupture of membranes at initial presentation with a sensitivity of 95.7% (179 of 187), specificity of 100% (24 of 24), positive predictive value of 100% (179 of 179), and negative predictive value of 75.0% (24 of 32). By comparison, the conventional standard diagnostic methods had a sensitivity of 78.1% (146 of 187), specificity of 100% (24 of 24), positive predictive value of 100% (146 of 146), and negative predictive value of 36.9% (24 of 65) in diagnosing rupture of membrane. Conclusion. Placental alpha-microglobulin-1 immunoassay is a rapid and accurate method for confirming the diagnosis of rupture of membrane. It was superior to conventional standard diagnostic methods (pooling, nitrazine, and ferning), the nitrazine test alone or fern test alone.
Department of Obstetrics and Gynaecology, UKM Medical Centre, Malaysia.
Beng Kwang
BK
Ng
Pei Shan
PS
Lim
Mohamad Nasir
MN
Shafiee
Nur Azurah Abdul
NA
Ghani
Nor Azlin Mohamed
NA
Ismail
Mohd Hashim
MH
Omar
Muhammad Abdul Jamil Muhammad
MA
Yassin
D000328:Adult; D000510:Alpha-Globulins / Q000378:metabolism*; D003710:Demography; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000175:diagnosis*; D006801:Humans; D007118:Immunoassay / Q000379:methods*; D011247:Pregnancy; D011933:Reagent Kits, Diagnostic / Q000592:standards*; D012015:Reference Standards
D000510:Alpha-Globulins; D011933:Reagent Kits, Diagnostic; C016001:alpha-1-microglobulin