Placental Alpha-Microglobulin-1 Test in Resource-Limited Settings

Echebiri, Nelson C.; Sinkey, Rachel G.; Szczepański, J; Shelton, James; McDoom, M. Maya; Odibo, Anthony O.

doi:10.1097/aog.0000000000001258

Cited by 5 publications

(3 citation statements)

References 24 publications

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“…Perhaps due to exchange rate and tax issues, the price of these tests is very expensive in Brazil, a country where the Unified Health System pays hospitals approximately 395 reais (US $ 105) for a cesarean delivery. Despite the study by Echebiri et al , who reported a favorable cost–benefit ratio for the use of PAMG‐1 when resources are limited, we believe that the use of immunochromatographic tests should be restricted to inconclusive cases with the presence of bleeding. However, we agree that studies specifically designed for this purpose, with a thorough economic assessment, should be performed in Brazil and in other developing countries to confirm this conclusion.…”

Section: Discussionmentioning

confidence: 70%

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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Section: Discussionmentioning

confidence: 70%

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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“…Fetal fibronectin is considered a biochemical marker of membrane/decidual activation, as is the increased expression of insulin growth factor binding protein (IGFBP)-1 [39][40][41][42][43][44][45][46][47][48][49][50][51][52] or α−1 microglobulin (also measurable with a PMG test in cervical and vaginal fluid) [53][54][55][56][57][58][59][60][61][62][63][64][65][66][67]. Membrane/decidual activation can be induced by the physiologic events that lead to spontaneous labor and delivery, or by pathologic insults, such as infection or inflammation [1,2,[5][6][7][8].…”

Section: Introductionmentioning

confidence: 99%

A high concentration of fetal fibronectin in cervical secretions increases the risk of intra-amniotic infection and inflammation in patients with preterm labor and intact membranes

Romero

Park

et al. 2019

Journal of Perinatal Medicine

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Objective To determine whether the risk of intra-amniotic infection/inflammation and spontaneous preterm delivery (SPTD) varies as a function of the concentration of cervical fetal fibronectin (fFN) in patients with preterm labor and intact membranes. Methods This prospective study included 180 patients with preterm labor and intact membranes who had a sample collected for quantitative fFN measurement and underwent amniocentesis. Amniotic fluid was cultured for aerobic and anaerobic bacteria and genital mycoplasmas. Intra-amniotic inflammation was defined as an amniotic fluid matrix metalloproteinase-8 concentration >23 ng/mL. Results (1) The prevalence of intra-amniotic infection/inflammation and SPTD within 7 days was 32.2% (58/180) and 33.9% (61/178), respectively; (2) The higher the fFN concentration, the greater the risk of intra-amniotic infection/inflammation and SPTD within 7 days (P<0.001, respectively); (3) An fFN concentration 150 ng/mL had a better diagnostic performance than an fFN 50 ng/mL in the identification of intra-amniotic infection/inflammation and SPTD within 7 days; (4) Among the patients with an fFN <50 ng/mL, intra-amniotic infection/inflammation was identified in 7.6% (6/79) of patients and 66.7% (4/6) delivered within 7 days. Conclusion The higher the concentration of fFN, the greater the risk of intra-amniotic infection/inflammation and SPTD in patients with preterm labor and intact membranes.

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“…Está asociado con una sensibilidad del orden del 5-30% y especificidad en el orden 5-12,9% de los pacientes. También es sabido de su fácil contaminación por otros factores como semen, orina, sangre y soluciones antisépticas (5).…”

Section: Introduccionunclassified

Utility of insulin-like growth factor-binding protein type 1 in premature membrane rupture

E¹,

2018

An. Fac. Cienc. Méd. (Asunción)

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RESUMENIntroducción: Fercuentemente no disponemos de una clara evidencia de la pérdida de líquido amniótico observado por examen con espéculo, por lo que el diagnóstico de rotura prematura de membranas puede ser con frecuencia incierto, por lo que se necesitan pruebas de diagnóstico apropiadas y complementarias para la toma de decisiones. Objetivo: conocer la precisión diagnóstica de la proteína-1 de unión al factor de crecimiento similar a la insulina (IGFBP-1) en la rotura prematura de membranas al compararla con la medición del bolsilla mayor por ecografía y el Test de de Ferning. Material y métodos: 102 gestantes de 24 a 37 semanas con signos y/o síntomas de rotura de membranas fueron elegibles, fueron evaluadas con las pruebas IGFBP-1, ecografía y Test de Ferning. Resultados: Para el IGFBP-1 se obtuvo 95% de sensibilidad (S), 95% de especificidad (E), 95% de valor predictivo positivo (VPP) y 96% de valor predictivo negativo (VPN). Par el Test de Fernig se obtuvieron valores de 85%, 25%, 25% y 83% respectivamente. En tanto que para la ecografía los hallazgos fueron de 81%, 29%, 56% y 58% respectivamente. Conclusión: el ensayo IGFBP-1 fue el método más preciso para diagnosticar la ruptura prematura de membranas con la mayor sensibilidad, especificidad, valor predictivo positivo y valor predictivo negativo.

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Placental Alpha-Microglobulin-1 Test in Resource-Limited Settings

Abstract: Among women presenting at resource-limited settings with a history suspicious of preterm premature rupture of membranes between 24 and 36 weeks of gestation, our analysis provides evidence suggesting that PAMG-1 is the most cost-effective testing strategy.

Cited by 5 publications

References 24 publications

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

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

A high concentration of fetal fibronectin in cervical secretions increases the risk of intra-amniotic infection and inflammation in patients with preterm labor and intact membranes

Utility of insulin-like growth factor-binding protein type 1 in premature membrane rupture

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