Value of non phosphorylated insulin-like growth factor binding protein-1 in cervical vaginal excretion and residual amniotic fluid index monitoring in the diagnosis of premature rupture of membranes

Abstract

Objective To explore the method of rapid diagnosis preterm premature rupture of membrane (PPROM)and prognosis factors of residual amniotic fluid in mother and infant through monitoring nonphosphorylated insulin-like growth factor binding protein-1(IGFBP-1)and the residual amniotic fluid index(AFI)of the cervi-covaginal secretions from PPROM women. Methods 96 cases of PPROM were tested IGFBP-1 of cervicovaginal secretions, AFI were tested by abdominal ultrasound through fast chromatography methods, and the cause was ana-lyzed. The pregnancy outcome and neonatal prognosis were compared. Results 92 cases positive of IGFBP-1 were diagnosed with PPROM. The risk factors of PPROM were mainly reproductive tract infections, abortion, induced labor history and unknown causes(including no evidence of infection, fetal membrane dysplasia unclear or other factors), the twins, multiplets, macrosomia, breech or cephalopelvic disproportion, gestational hypertension disease, uterine fibroids or deformity, malnutrition and polyhydramnios. In the 92 patients with PPROM pregnant women, the duration from premature rupture of membrane to delivery was(105.7±13.9)h, cesarean section rate was 51.1%, fever rate of pregnant women was 7.6%, the rate of placental abruption was 4.3%,the rate of fetal distress was14.1%, perinatal infection rate was 21.7%, and neonatal asphyxia rate was 7.6%, the neonatal mortality was 7.6%. To compare the AFI≤40mm group with AFI＞40 mm group, the duration from premature rupture of membrane to delivery was short-ened remarkably(t＝10.904,P＜0.05), the neonatal mortality rate was significantly increased(χ2＝4.359,P＜0.05). Conclusion Measurement of IGFBP-1 and AFI in cervicovaginal secretions can rapid diagnosis PPROM and evaluate the results of pregnancy and neonatal prognosis, and can guide clinical improvement of pregnancy safety and reduce neonatal mortality. Key words: Premature rupture of membranes; Insulin-like growth factor binding protein-1; Amniotic fluid index; Diagnose