COMPARISON BETWEEN PLACENTAL ALPHA MICROGLOBULIN 1 (AMNISURE) RAPID IMMUNOASSAY AND STANDARD CLINICAL METHOD FOR DIAGNOSIS OF PREMATURE RUPTURE OF MEMBRANES IN IDO EKITI
Background: Premature rupture of membranes is an important obstetric
condition that poses significant risk to the wellbeing of the foetus in-utero, constituting a source of morbidity and possible mortality if not appropriately diagnosed and managed. Approximately 8% to 10% of term pregnancies will experience spontaneous rupture of membranes prior to the onset of labour. An accurate diagnosis with prompt and correct intervention is of utmost importance in the management of rupture of membranes especially in preterm gestation. The search for accuracy and increased specificity in diagnosis of premature rupture of membrane is an ongoing process.
Objective: To determine the accuracy of placental alpha micro globulin 1(PAMG 1) Amnisure ROM in diagnosing presence of amniotic fluid in cervicovaginal secretions and hence diagnose rupture of fetal membranes.
To compare Amnisure ROM with standard clinical assessment in diagnosing rupture of fetal membranes.
To determine and compare the sensitivity and specificity of amnisure ROM and standard clinical assessment in diagnosis of premature rupture of membranes.
Methodology: All pregnant women with symptoms suggestive of premature rupture of membrane such as trickling or gush of fluid per vagina were evaluated using the amnisure ROM kit and standard clinical evaluation and findings noted on appropriate proforma.
Data analysis: Data collected using the proforma was subjected to statistical analysis using SPSS version 18.
Results: A total number of 64 patients were recruited , the mean age was 29.6 ± 3.4years.The mean gravidity was 3.0 ± 1.4, with a mean parity of 1.3 ± 1.3 while the mean gestational age at presentation was 37.2 ± 2.4 weeks. The amnisure test and standard clinical assessment were positive in 45(70.3%) patients and negative in 11(17.2%) patients. A total of 52(81.2%) patients had positive results following amnisure test while 46(71.2%) had positive results following standard clinical assessment. There was disparity in test results in 8(12.5%) patients, 7(10.9%) of which were positive in the amnisure test and negative in the standard clinical assessment while 1(1.6%) patient was negative following amnisure assay and positive following standard clinical assessment. The patients with true positive result were 54(84.3%), true negative 10(15.6%). The sensitivity, specificity, positive predictive value and negative predictive value were 96.3%, 100%, 100% and 83.3% following amnisure test and 84.3%, 100%, 100% and 55.6% following standard clinical assessment for the diagnosis of premature rupture of membranes.
Conclusion: Placental alpha-microglobulin-1 immunoassay is a rapid and accurate method for confirming the diagnosis of rupture of membrane. It was superior to conventional standard diagnostic methods