Role of vaginal washing fluid alpha-foetoprotein in diagnosing premature rupture of membranes and correlating it with the onset of labour
Background: The traditional methods of diagnosing premature rupture of membranes (PROM) have limitations, particularly in diagnosing equivocal cases. Hence, novel methods such as identification of biochemical markers in amniotic fluid, which can be detected in the setting of PROM, have been sought....
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer Medknow Publications
2011-01-01
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| Series: | Current Medicine Research and Practice |
| Subjects: | |
| Online Access: | http://www.cmrpjournal.org/article.asp?issn=2352-0817;year=2011;volume=1;issue=5;spage=238;epage=242;aulast=Tigga |
| Summary: | Background: The traditional methods of diagnosing premature rupture of membranes (PROM) have limitations, particularly in diagnosing equivocal cases. Hence, novel methods such as identification of biochemical markers in amniotic fluid, which can be detected in the setting of PROM, have been sought. a-foetoprotein (AFP) is one of such markers which has a high amniotic fluid concentration as compared to normal vaginal secretions. Objective: To evaluate the reliability of AFP levels in vaginal washing fluid for the diagnosis of PROM and to correlate it with the duration of onset of labour. Methods: Fifty pregnant women between 20 and 40 weeks of gestation with a history of leaking per vaginam (study group) and an equal number of gestation-matched pregnant women without leak (control group) were recruited from the antenatal clinic or labour room of Safdarjung Hospital, New Delhi. Speculum examination was done for all women to collect sample vaginal washings for AFP assay. The duration of PROM to onset of labour was recorded in the study subjects. Outcome measures: The primary outcome was the level of AFP to diagnose PROM. The secondary outcome was the correlation of AFP levels with the duration of PROM to onset of labour. Results: The vaginal washing concentration of AFP was significantly higher in the study group than in the control group (56.81±7.3 vs. 22.58±10.6 ng/ml; p=0.000). The cut-off level of AFP to diagnose PROM obtained from the receiver operating characteristics (ROC) curve was 45.9 ng/mL. The sensitivity, specificity, positive and negative predictive values, for AFP to diagnose PROM were: 98%, 94%, 94.2% and 97.9%, respectively. The correlation coefficient of vaginal washings AFP levels and duration of PROM to onset of labour was –0.757 (p=0.000). Conclusion: AFP is a reliable marker for diagnosing PROM and pregnant women with higher level of vaginal washings AFP had an earlier onset of labour. |
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| ISSN: | 2352-0817 2352-0825 |