Insulin‐like growth factor binding protein‐1 (Actim PROM test) for detection of premature rupture of fetal membranes

Abstract

This study was designed to detect the accuracy of the insulin-like growth factor binding protein-1 (IGFBP-1) in diagnosing premature rupture of fetal membranes. A total of 150 pregnant women after 37 weeks' gestation were included in this study and divided into two groups according to presence or absence of premature rupture of the membranes (PROM); 75 patients with PROM were included in group I and 75 patients without PROM were included in group II as controls. The diagnosis of PROM was based on patient's history of sudden gush of water, pooling of amniotic fluid, positive Ferning pattern, positive Nitrazine test, confirmed by visualization of fluid passing from the cervical canal during sterile speculum examination and transabdominal ultrasound to measure the amniotic fluid index. In this study, the sensitivity and the specificity of IGFBP-1 (Actim PROM test) in diagnosing PROM were 89.3% and 82.7%, respectively, as compared with 84% sensitivity and 78.7% specificity for Ferning test, and 86.7% sensitivity and 81.3% specificity for Nitrazine test. The positive predictive value (PPV) and negative predictive value (NPV) of IGFBP-1 were 83.8% and 88.6%, respectively, as compared with 79.7% PPV and 83.1% NPV for the Ferning test, and 82.2% PPV and 85.9% NPV for the Nitrazine test. The IGFBP-1 was more accurate (86%) for detection of PROM than the Ferning (81.3%) or Nitrazine (84.0%) tests. The Actim PROM test for detection of IGFBP-1 in the vaginal fluid is a simple bedside test and can be used as a complimentary test to confirm the clinical diagnosis of PROM.