INSULIN-LIKE-GROWTH-FACTOR BINDING PROTEIN-1, A QUICK WAY TO DETECT AMNIOTIC-FLUID

Background The detection of premature rupture of membranes (FROM) is e ssential to the management of pregnancy. Various tests, all with diffe rent limitations, have been used to diagnose FROM. Insulin-like growth factor binding protein-1 (IGFBP-1) is present in an essentially highe r concentration in amniotic fluid, than in serum, cervical mucous, uri ne and seminal plasma. A commercial kit, with monoclonal antibodies to IGFBF-1 attached to a stick, is available. The aim of this study was to investigate whether a rapid dipstick test could confirm or exclude the presence of amniotic fluid. Methods. A multicenter study, involvin g six departments of obstetrics and gynecology in Sweden, was designed to evaluate the new dipstick technique of diagnosing the presence of amniotic fluid in the vagina. One hundred and seventy-four women were examined. Forty-six women with obvious FROM, 29 women without FROM and 99 women with suspected FROM. Results. Forty-four out of forty-six wo men with obvious FROM had a positive FROM-TEST. Twenty-seven out of tw enty-nine women without FROM had a negative FROM-TEST, giving a sensit ivity of 95.7% and a specificity of 93.1%. Among the women with suspec ted rupture of membranes, the sensitivity was 70.8%, the specificity 8 8.2% and the positive predictive value (PPV) 92%. Conclusion. IGFBP is present in high concentration in amniotic fluid. The dipstick test wi th monoclonal antibodies to IGFBP-1 is rapid and has a high PPS sensit ivity and specificity. It is a useful complement to the existing arsen al of teals to detect FROM.