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Placental α-microglobulin-1 to detect uncertain rupture of membranes in a European cohort of pregnancies

Birkenmaier, Ariane ; Ries, Jean-Jacques ; Kuhle, Jens ; Bürki, Nicole ; Lapaire, Olav ; Hösli, Irene

In: Archives of Gynecology and Obstetrics, 2012, vol. 285, no. 1, p. 21-25

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    Title
    • Placental α-microglobulin-1 to detect uncertain rupture of membranes in a European cohort of pregnancies
    Author
    • Birkenmaier, Ariane. Department of Obstetrics and Gynaecology, University Hospital Basel, University of Basel, Spitalstr. 21, 4031, Basel, Switzerland
    • Ries, Jean-Jacques. Department of Obstetrics and Gynaecology, University Hospital Basel, University of Basel, Spitalstr. 21, 4031, Basel, Switzerland
    • Kuhle, Jens. Neurology and Department of Biomedicine, University Hospital Basel, University of Basel, Basel, Switzerland
    • Bürki, Nicole. Department of Obstetrics and Gynaecology, Kantonsspital Liestal, Liestal, Switzerland
    • Lapaire, Olav. Department of Obstetrics and Gynaecology, University Hospital Basel, University of Basel, Spitalstr. 21, 4031, Basel, Switzerland
    • Hösli, Irene. Department of Obstetrics and Gynaecology, University Hospital Basel, University of Basel, Spitalstr. 21, 4031, Basel, Switzerland
    Document Type
    • Postprint
    OAI-PMH Identifier
    • oai:doc.rero.ch:317091
    Summary
    Purpose: We evaluated the performance of the placental alpha-microglobulin-1 immunoassay (AmniSure®, AT) in cervicovaginal secretions in patients with uncertain rupture of membranes (ROM) and investigated the influence of the examiners experience. Methods: This prospective cohort study was performed in pregnant women (17-42weeks of gestation) with signs of possible ROM. Evaluation included clinical assessment, examination for cervical leakage, Nitrazine test and measurement of the amniotic fluid index by ultrasound and AT. ROM occurrence was based on review of the medical records after delivery. Results: 199 women were included. AT had a sensitivity of 94.4%; specificity of 98.6%; positive predictive value, 96.2%; negative predictive value, 98.0%. Clinical assessment showed a sensitivity of 72.2%; specificity of 97.8%; positive predictive value, 92.9%; negative predictive value, 90.6%. AT was more sensitive for diagnosing ROM (p=0.00596) compared to clinical assessment, independent of the examiners experience. Furthermore, the sole use of AT reduced costs by 58.4% compared to clinical assessment. Conclusions: AT was more sensitive compared to clinical assessment, independent of the examiners experience and gestational age. Our data extend its use in patients with uncertain ROM. Moreover, AT seems to be a cost-effective approach in the assessment of these patients