ABSTRACT

To evaluate the clinical value of insulin like growth factor binding protein-1 (IGFB-1) for detection of rupture of membranes in women with preterm labor and advanced cervical dilatation.

Seventy-eight women with the diagnosis of preterm labor were evaluated, 44 of who also had complaints of vaginal fluid leakage. IGFB-1 level was measured in cervical and vaginal secretions of pregnant women in preterm labor using immunochromatography. Definitive diagnosis of rupture of membranes (ROM) was made using the combination of nitrazine test, amniotic fluid index follow-up, repeated speculum examinations and evaluating the presence of vaginal infections.

Thirty-four women (43%) had the diagnosis of ROM. A positive IGFBP-1 test was detected in 30 (88.2%) women with ROM and 8 (18.2%) women without ROM. The sensitivity of IGFBP-1 detection for the diagnosis of ROM as a single step test in the presence of preterm labor and advanced cervical dilatation was 88% while the specificity was 81%, positive predictive value was 79% and negative predictive value was 90%.

IGFBP-1 detection in cervical and vaginal secretions is a valuable single step test in the diagnosis of ruptured membranes even in cases with preterm labor and dilated cervices. It can be used as an adjunct to clinical examination.

Keywords: IGFBP-1, preterm labor, rupture of membranes, diagnosis