Comparison of the Duo of Insulin-Like Growth Factor Binding Protein-1/Alpha Fetoprotein (Amnioquick Duo+®) and Nitrazine Test for Diagnosing Query Rupture of Fetal Membranes

Abstract

Background: premature rupture of membranes (PROM) constitutes one of the most important dilemmas in the obstetric practice. It could be defined as rupture of membranes before the onset of labour, irrespective of the gestational age. It is associated with infectious morbidity in mother and fetus, cord accidents, imminent term or preterm labour. For these reasons, its correct diagnosis is very important. A novel test used for diagnosing rupture of membranes (ROM) is Amnioquick duo+® (Biosynex, Strasbourg Cedex, France). Amnioquick duo+® is a rapid strip test with immunoassay that is simple, easy to perform, quick and noninvasive. It is an immunochromatographic test that identifies even trace amounts of both alpha fetoprotein (AFP) and insulin-like growth factor binding protein-1 (IGFBP-1). On other hand the traditional methods for diagnosis of PROM are through the patient’s history, leakage, ferning test and nitrazine test. Aim of the Work: the aim of this study is to compare the accuracy of the duo of insulin-like growth factor binding protein-1/alpha fetoprotein (Amnioquick duo+®) and nitrazine test for diagnosing query rupture of fetal membranes in pregnant women with query PROM. Patients and Methods: this comparative cross sectional study was carried out at Ain Shams University Maternity Hospital between November 2017 to June 2018. Results: a total of one hundred and thirteen pregnant women > 24 weeks of gestation were included in the study with age ranging between 18 and 42 years (mean ± SD, 27 ± 6 years). Thirty eight (33.6%) women were primigravidae and 75 (66.4%) were multigravidae. Forty (35.4%) women were primiparas while 63 (64.6%) were multiparas. Twenty five (22.1%) women experienced one or more previous abortion. The Amnioquick duo+® test was more specific and accuracy in diagnosing rupture of membranes than Nitrazine test. The sensitivity and the specificity of Amnioquick duo+® test in diagnosing PROM was 100% and 97.3% respectively as compared to Nitrazine test which was 100% and 83%. The PPV and NPV of Amnioquick duo+® test were 98.7% and 100% as compared to Nitrazine test which were 92.7% and 100%. Conclusion: this study concluded that IGFBP-1/AFP (AmnioQuick® Duo+) test is rapid reliable non-invasive, easy and accurate bedside immunoassay test, better than nitrazine test and can used as complementary test to improve the management of women with women premature fetal membranes rupture.