title: Alpha-foetoprotein in the diagnosis of prelabour rupture of membranes.
abstract: BACKGROUND
  Prelabour rupture of membranes (PROM) complicates overall 10% of gestations which include 7% at term and 3 % preterm gestations. Making an early and accurate diagnosis of PROM is important, to allow gestational age specific obstetric interventions and to optimize perinatal outcome.
  
  
  OBJECTIVE
  To study the efficacy of alpha-foeto protein in cervicovaginal secretions, to diagnose prelabour rupture of membranes.
  
  
  METHODS
  A tertiary care centre.
  
  
  METHODS
  We performed a prospective study on 130 patients who were at ≥ 24 weeks of gestation, who had complaint of leaking per vagina, between September 2011 and August 2013. Alpha-foetoprotein test was perfomed on cervicovaginal secretions which were collected during per-speculum examinations. A diagnosis of prelabour rupture of membranes was made, based on combined clinical diagnosis which was made during hospital stay of the patients prospectively. The efficacy of Alpha-foetoprotein was studied. Stastical Analysis: Chi-square test, Kappa analysis.
  
  
  RESULTS
  The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of Alpha-foetoprotein were 88.9%, 98.5%, 98.3%, 90.1% and 93.8% respectively. Degree of agreement of Alpha-foetoprotein with combined clinical diagnosis was 0.875.
  
  
  CONCLUSIONS
  Assessment of alpha-foetoprotein levels in cervi-covaginal secretions can be used as a reliable test to diagnose prelabour rupture of membranes when faced with a diagnostic dilemma.
authors.affiliation: Postgrauate, Department of Obstetrics and Gynaecology, Kasturba Medical College , Manipal, India .
authors.forename: Chhavi Rana
authors.initials: CR
authors.lastname: Singh
authors.affiliation: Associate Professor, Department of Obstetrics and Gynaecology, Kasturba Medical College , Manipal, India .
authors.forename: Rajeshwari Gurumoorthy
authors.initials: RG
authors.lastname: Bhat
keywords: Alpha-foetoprotein; Combined clinical diagnosis; Prelabour rupture of membranes