Insulin-like growth factor binding protein-1 (Actim PROM test®) for detection of premature rupture of fetal membranes

ObjectiveTo detect the accuracy of the IGFBP-1 in diagnosing premature rupture of fetal membranes.MethodsOne hundred and fifty pregnant women after 37 weeks gestation were included in this study and divided into two groups according to presence or absence of PROM; 75 patients with PROM were included in group I and 75 patients without PROM were included in group II as controls. The diagnosis of PROM was based on patient's history of sudden gush of water, pooling of amniotic fluid, positive Ferning pattern, positive Nitrazine test, confirmed by visualization of fluid passing from the cervical canal during sterile speculum examination and Trans-abdominal ultrasound to measure the amniotic fluid index.ResultsIn this study, the sensitivity and the specificity of IGFBP-1 (Actim PROM test®) in diagnosing PROM were 89.3% & 82.7%, respectively, as compared with 84% sensitivity & 78.7% specificity for Ferning test, and 86.7% sensitivity & 81.3% specificity for Nitrazine test. The PPV and NPV of IGFBP-1 (Actim PROM test®) were 83.8% & 88.6%, respectively, as compared with 79.7% PPV & 83.1% NPV for Ferning test, and 82.2% PPV & 85.9% NPV for Nitrazine test. The IGFBP-1 (Actim PROM test®) was more accurate (86%) for detection of PROM than Ferning (81.3%) or Nitrazine (84.0%) tests.ConclusionThe Actim PROM test®, for detection of IGFBP-1 in the vaginal fluid is a simple bedside test, and can be used as complimentary test to confirm the clinical diagnosis of Premature rupture of fetal membranes.