Authors’ Response

Abstract

We thank Birkenmaier et al. for their interest in our paper, and read with interest their publication on this subject [ [1] Birkenmaier A. Ries J.J. Kuhle J. Bürki N. Lapaire O. Hösli I. Placental alpha-microglobulin-1 to detect uncertain rupture of membranes in a European cohort of pregnancies. Archives of Gynecology and Obstetrics. 2012; 285: 21-25 Crossref PubMed Scopus (29) Google Scholar ]. Indeed, their study was not included in our review, which included studies until September 2009 [ [2] van der Ham D.P. van Melick M.J. Smits L. et al. Methods for the diagnosis of rupture of the fetal membranes in equivocal cases: a systematic review. European Journal of Obstetrics, Gynecology, and Reproductive Biology. 2011; 157: 123-127 Abstract Full Text Full Text PDF PubMed Scopus (29) Google Scholar ]. We agree with the authors that there is a need for a reliable, less intrusive, cost effective and minimally invasive test to diagnose rupture of membranes. With their paper the authors have contributed to the search for a reliable diagnostic test. We also agree that further studies should evaluate the performance of the placental alpha-microglobulin-1 immunoassay (AmniSure©). However, when current RCT's on the management of PPROM [ 3 Morris J.M. Roberts C.L. Crowther C.A. Buchanan S.L. Henderson-Smart D.L. Salkeld G. Protocol for the immediate delivery versus expectant care of women with preterm prelabour rupture of the membranes close to term (PPROMT) Trial [ISRCTN44485060]. BMC Pregnancy Childbirth. 2006; 6: 9 Crossref PubMed Scopus (40) Google Scholar , 4 van der Ham D.P. Nijhuis J.G. Mol B.W. et al. Induction of labour versus expectant management in women with preterm prelabour rupture of membranes between 34 and 37 weeks (the PPROMEXIL-trial). BMC Pregnancy Childbirth. 2007; 7: 11 Crossref PubMed Scopus (39) Google Scholar ] confirm the findings of a recent Cochrane analysis [ [5] Buchanan S.L. Crowther C.A. Levett K.M. Middelton P. Morris J. Planned early birth versus expectant management for women with preterm prelabour rupture of membranes prior to 37 weeks’ gestation for improving pregnancy outcome. Cochrane Database of Systematic Reviews. 2010; 3: CD004735 PubMed Google Scholar ] which did not find a reduction in adverse neonatal outcome after induction of labor, one might even debate whether one needs to know whether the membranes are ruptured in equivocal cases. Expectant management would then be the most appropriate choice in all such cases. Methods for the diagnosis of rupture of the fetal membranes in equivocal casesEuropean Journal of Obstetrics and Gynecology and Reproductive BiologyVol. 161Issue 1PreviewIt was with great pleasure that we read the recent meta-analysis on the methods available for the diagnosis of rupture of the fetal membranes (ROM) in equivocal cases [1]. The same curiosity that likely generated this analysis also drove our recently completed and published clinical investigation regarding the utility of the commercially available test for placental alpha microglobulin-1 [PAMG-1] (AmniSure® ROM Test, AmniSure® International LLC, Boston, MA, USA) in cases with uncertain rupture of membranes [2]. Full-Text PDF Methods for the diagnosis of rupture of the fetal membranes in equivocal cases: a systematic reviewEuropean Journal of Obstetrics and Gynecology and Reproductive BiologyVol. 157Issue 2PreviewPrelabor rupture of membranes (PROM) is a common obstetrical problem, but its diagnosis is frequently problematic. Lacking a gold standard, the diagnosis is equivocal in some 10% of cases. We performed a systematic review to assess the accuracy of several tests for the diagnosis of PROM in these equivocal cases. We performed an electronic search in PubMed, Embase, DARE and the Cochrane Library and reference lists for potentially missed articles. No language restrictions were used. Only accuracy studies for diagnostic methods for PROM in women with equivocal PROM were selected. Full-Text PDF