title: Diagnostic performance of placental alpha-microglobulin-1 test in women with prolonged pre-labour rupture of membranes.
abstract: OBJECTIVE
  To determine diagnostic performance of placental alpha-microglobulin-1 (PAMG-1) test compared to conventional clinical assessment (CCA) in women with prolonged pre-labour rupture of membranes (PROM).
  
  
  METHODS
  A double-blind study of women with symptoms and signs of PROM in Nnamdi Azikiwe University Teaching Hospital, Nnewi and University of Nigeria Teaching Hospital, Enugu, in south-east Nigeria using CCA for PROM and PAMG-1 test was done. Women were included if their symptoms, signs or complaints suggestive of PROM was more than 24 h duration. PROM was diagnosed if two out of three methods from CCA (pooling, positive nitrazine test or ferning) were present. Confirmation of PROM was done after delivery using any two of these clinical criteria: delivery in 48 h to 7 days, evidence of chorioamnionitis, membranes obviously ruptured at delivery and adverse perinatal outcomes strongly correlated with prolonged PROM.
  
  
  RESULTS
  Accuracy, specificity and sensitivity value for CCA were 72.5, 36.8 and 86.0% lower than for PAMG-1 test which were 95.7, 94.1 and 96.2%. In equivocal cases, PAMG-1 was significantly more accurate than CCA (92.3% versus 38.5%; p < 0.001).
  
  
  CONCLUSIONS
  This study in women with prolonged PROM, confirms that PAMG-1 test has high diagnostic accuracy irrespective of the duration of PROM before clinical evaluation.
authors.affiliation: a Department of Obstetrics and Gynaecology , Nnamdi Azikiwe University Teaching Hospital , Nnewi , Nigeria .|b Effective Care Research Unit , Nnamdi Azikiwe University , Nnewi Campus , Nigeria .
authors.forename: George Uchenna
authors.initials: GU
authors.lastname: Eleje
authors.affiliation: c Department of Obstetrics and Gynaecology , University of Nigeria Teaching Hospital , Ituku-Ozalla, Enugu , Enugu State , Nigeria .
authors.forename: Euzebus Chinonye
authors.initials: EC
authors.lastname: Ezugwu
authors.affiliation: d Department of Obstetrics and Gynaecology , Michigan State University School of Medicine/Sparrow Hospital , Lansing , MI , USA .
authors.forename: Ahizechukwu Chigoziem
authors.initials: AC
authors.lastname: Eke
authors.affiliation: e Measurement and Evaluation Unit, Department of Education Foundation , Nnamdi Azikiwe University Awka , Anambra State , Nigeria .
authors.forename: Lydia Ijeoma
authors.initials: LI
authors.lastname: Eleje
authors.affiliation: a Department of Obstetrics and Gynaecology , Nnamdi Azikiwe University Teaching Hospital , Nnewi , Nigeria .|b Effective Care Research Unit , Nnamdi Azikiwe University , Nnewi Campus , Nigeria .
authors.forename: Joseph Ifeanyichukwu
authors.initials: JI
authors.lastname: Ikechebelu
authors.affiliation: b Effective Care Research Unit , Nnamdi Azikiwe University , Nnewi Campus , Nigeria .|f Office of the Chairman, Medical Adivisory Committee, Nnamdi Azikiwe University Teaching Hospital , Nnewi , Anambra State , Nigeria , and.
authors.forename: Evaristus Anthony
authors.initials: EA
authors.lastname: Afiadigwe
authors.affiliation: g Department of Obstetrics and Gynaecology , ESUT Teaching Hospital , Parklane, Enugu , Enugu State , Nigeria.
authors.forename: Frank O
authors.initials: FO
authors.lastname: Ezugwu
authors.affiliation: a Department of Obstetrics and Gynaecology , Nnamdi Azikiwe University Teaching Hospital , Nnewi , Nigeria .|b Effective Care Research Unit , Nnamdi Azikiwe University , Nnewi Campus , Nigeria .
authors.forename: Gerald Okanandu
authors.initials: GO
authors.lastname: Udigwe
authors.affiliation: a Department of Obstetrics and Gynaecology , Nnamdi Azikiwe University Teaching Hospital , Nnewi , Nigeria .
authors.forename: Charles I
authors.initials: CI
authors.lastname: Okafor
authors.affiliation: a Department of Obstetrics and Gynaecology , Nnamdi Azikiwe University Teaching Hospital , Nnewi , Nigeria .|b Effective Care Research Unit , Nnamdi Azikiwe University , Nnewi Campus , Nigeria .
authors.forename: Chukwuemeka Okwudili
authors.initials: CO
authors.lastname: Ezeama
mesh_terms: D000328:Adult; D000653:Amniotic Fluid / Q000378:metabolism*; D015415:Biomarkers / Q000378:metabolism; D004311:Double-Blind Method; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000175:diagnosis*; D006801:Humans; D007118:Immunoassay; D018970:Insulin-Like Growth Factor Binding Protein 1 / Q000378:metabolism*; D010920:Placenta / Q000378:metabolism*; D000067716:Point-of-Care Testing; D011247:Pregnancy; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D055815:Young Adult
chemical_list: D015415:Biomarkers; C032231:IGFBP1 protein, human; D018970:Insulin-Like Growth Factor Binding Protein 1
keywords: Accuracy; PAMG-1; conventional clinical assessment; prolonged rupture of membranes