Effect of blood on ROM diagnosis accuracy of PAMG-1 and IGFBP-1 detecting rapid tests

Ramsauer, B.; Duwe, W; Schlehe, B.; Pitts, Regina; Wagner, Dirk; Wutkewicz, Katja; Chuvashkin, Dmitry; Abele, Harald; Lachmann, Robert

doi:10.1515/jpm-2014-0227

Cited by 14 publications

(11 citation statements)

References 17 publications

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“…(AmniSure GmbH, Wetzlar, Germany), which is a one-step immunochromatographic assay, was performed on maternal urine, AMF and ALF. Samples with macroscopic blood contamination were also used, as it seems that blood does not interfere with the test results [10]. The test procedure and reading of results was carried out according to the manufacturer's instructions (www.amnisure.com), except that the sterile swab provided to collect the sample from the vagina in women was dipped for 1 min into the collection tube containing either urine or one of the fetal fluids.…”

Section: Calcium (Ca) and Magnesium (Mg) Concentration: The Total Harmentioning

confidence: 99%

“…The AmniSure ® Test (AmniSure GmbH, Wetzlar, Germany) is based on the detection of placental α-microglobulin-1 (PAMG-1), as this protein is present in higher concentrations in AMF compared to other biological fluids [6,7] and is used as a biomarker [8,9]. Even small amounts of AMF can accurately be detected in vaginal fluids with the AmniSure ® Test, and it appears that artifacts from blood contamination do not significantly interfere with the test's performance [10]. No AMF or ALF-specific proteins have been identified for dogs, and the AmniSure ® Test has not been evaluated on canine fetal fluids.…”

Section: Introductionmentioning

confidence: 99%

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The use of semi-quantitative tests at Cesarean section delivery for the differentiation of canine fetal fluids from maternal urine on the basis of biochemical characteristics

et al. 2017

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In dogs, there is no diagnostic test to identify and differentiate fetal fluids from maternal urine in the event that a clear-yellowish vulvar discharge is observed pre-whelping. The objective of this study was to find a test that could easily and accurately identify rupture of the fetal membranes preceding parturition. Maternal urine, and amniotic fluid (AMF) and allantoic fluid (ALF) from only one fetus per bitch, were collected intraoperatively during Cesarean section. Specific gravity (SG) was analyzed with a refractometer, whereas the presence of leukocytes, protein, glucose, ketones, bilirubin, urobilinogen, nitrite, erythrocyte/hemoglobin (Hb), and the pH were assessed using a urine dipstick (Combur-Test). Combined calcium and magnesium (Ca/Mg) content were evaluated with the Total Hardness Test. The AmniSure test, which detects rupture of fetal membranes in women on the basis of the presence of human placental alpha microglobulin-1, was also performed on canine AMF, ALF, and urine. Data were analyzed using the Fisher's exact test, Wilcoxon signed-rank test, and Pearson's correlation. Sensitivity, specificity, and positive and negative likelihood ratios (LR) were calculated for parameters with significant difference between urine and both fetal fluids. Maternal urine had higher SG and lower leukocyte, protein, Hb, and Ca/Mg content than AMF and ALF. Glucose was more often present in AMF (n = 17) and ALF (n = 12) than in urine (n = 1), whereas ketone bodies were rarely detected in ALF compared with urine. Bilirubin content was higher in urine and ALF than in AMF. AMF pH was less variable and higher than the pH of ALF or urine. The AmniSure was negative in all samples tested. Sensitivity and specificity for SG and for the detection of leukocytes, protein, glucose, Hb, Ca/Mg, and glucose without ketones in urine and fetal fluids were between 42% to 100% and 65% to 100%, respectively. Best positive LR was achieved for the detection of glucose without ketones and best negative LR for SG of 1.022 or less. In conclusion, the AmniSure test, which is used in humans with high diagnostic accuracy, cannot identify AMF and ALF in dogs. On the basis of our results in 26 dogs undergoing Cesarean section, the presence or absence of fetal fluids could be best determined by a positive glucose test without ketone bodies or by SG higher than 1.022, respectively. These tests may serve as additional tools to recognize parturition if clear-yellowish vulvar discharge is present in a term pregnant bitch, but their accuracy and practicability in the clinical setting need to be confirmed.

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Section: Calcium (Ca) and Magnesium (Mg) Concentration: The Total Harmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The use of semi-quantitative tests at Cesarean section delivery for the differentiation of canine fetal fluids from maternal urine on the basis of biochemical characteristics

et al. 2017

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“…Few studies have performed a direct comparison simultaneously between the two immunochromatographic tests, as we did in the present study . With the aim of facilitating an understanding and comparative analysis with our research, we present these previous studies in detail in Table .…”

Section: Discussionmentioning

confidence: 99%

Comparative analysis of Insulin‐like growth factor binding protein‐1, placental alpha‐microglobulin‐1, phenol and pH for the diagnosis of preterm premature rupture of membranes between 20 and 36 weeks

Galletta

Bittar

Rodrigues

et al. 2019

J of Obstet and Gynaecol

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Aim: Preterm premature rupture of membranes (PPROM) is responsible for approximately one-third of premature births worldwide, and although the diagnosis is often straightforward, this condition can still present difficulties. The purpose of this research was to compare the accuracy of several PPROM diagnostic tests. Methods: A total of 94 pregnant women with clinical suspicion of PPROM who were between 20 and 36 weeks of pregnancy were examined by vaginal speculum, and tests were performed for phenol, pH, insulin-like growth factor binding protein-1 (IGFBP-1) and placental alpha-microglobulin-1 (PAMG-1). All patients were followed up until the diagnosis was fully defined, and a diagnosis of PROM was confirmed by a definitive evolution of the clinical symptoms (visualization of vaginal amniotic fluid or persistence of oligohydramnios). Results: After excluding the cases that could not be definitively diagnosed, a good diagnostic performance of the immunochromatographic tests was observed that was superior to that of the clinical tests. Similar accuracies were observed for IGFBP-1 (98.7%) and PAMG-1 (93.9%). However, while the IGFBP-1 test differed from a vaginal pH ≥7 (88.9%) and the phenol test (85.7%), this did not occur for the PAMG-1 test. The performance of the tests was modified only by the presence of bleeding (with lower specificity rates for pH and phenol), without interference of gestational age or maternal morbidities. Conclusion: Immunochromatographic tests are good tools but should be used sparingly in resource-poor settings because they are expensive, and there is no significant difference between PAMG-1 and traditional tests.Comparative analysis of PPROM markers patients signed an informed consent form after which they were enrolled in the study.

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“…A few years later, Ramsauer et al. deepened their research by studying the influence of blood on the diagnostic accuracy of PAMG‐1 and phIGFBP‐1 tests in rupture of fetal membranes . The presence of blood may lead to false positive results with biochemical markers.…”

Section: Prediction Of P‐prom and P‐prom/preterm Delivery Latencymentioning

confidence: 99%

“…A few years later, Ramsauer et al deepened their research by studying the influence of blood on the diagnostic accuracy of PAMG-1 and phIGFBP-1 tests in rupture of fetal membranes. 42 The presence of blood may lead to false positive results with biochemical markers. This study observed that the PAMG-1 detecting test was significantly less susceptible to interference by blood than the IGFBP-1 detecting test in all quality parameters evaluated (sensitivity was 97.8% vs 91.0%, specificity was 91.5% vs 75.0%, PPV was 94.6% vs 83.5%, and NPV was 96.4% vs 85.7%).…”

Section: Ramsauer Et Al Compared the Performance Of Tests Based On Tmentioning

confidence: 99%

Good clinical practice advice: Prediction of preterm labor and preterm premature rupture of membranes

Renzo¹,

Fonseca²,

Gratacós³

et al. 2019

Intl J Gynecology & Obste

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Effect of blood on ROM diagnosis accuracy of PAMG-1 and IGFBP-1 detecting rapid tests

Cited by 14 publications

References 17 publications

The use of semi-quantitative tests at Cesarean section delivery for the differentiation of canine fetal fluids from maternal urine on the basis of biochemical characteristics

The use of semi-quantitative tests at Cesarean section delivery for the differentiation of canine fetal fluids from maternal urine on the basis of biochemical characteristics

Comparative analysis of Insulin‐like growth factor binding protein‐1, placental alpha‐microglobulin‐1, phenol and pH for the diagnosis of preterm premature rupture of membranes between 20 and 36 weeks

Good clinical practice advice: Prediction of preterm labor and preterm premature rupture of membranes

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