THE ACCURATE DIAGNOSIS OF PREMATURE RUPTURE OF MEMBRANES AND THE USE OF PLACENTAL ALPHA-MICROGLOBULIN-1 TEST BY A PREGNANT WOMAN WITHOUT ANY ASSISTANCE


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Abstract

Objective. To determine the accuracy of diagnosis of premature rupture of membranes (PROM), by applying routine studies and the placental alpha-microglobulin-1 (PAMG-1) test, and the possibility of its use without assistance at home. Subject and methods. One hundred and seven pregnant women who had on referral these or those complaints and symptoms, which could be considered as signs of PROM; however, its diagnosis was not obvious in all cases. Before the examination, the patient was proposed to use the AmniSure ROM test intended to diagnose ruptured fetal membranes, by determining PAMG-1. The patient carried out the test without any assistance from the healthcare personnel according to the instruction given by its manufacturer in the package. The membranes were then evaluated by the physician who performed twice the routine tests: mirror examination, vaginal discharge microscopy, and nitrazine test. Their status was finally verified from a further follow-up of the patient during pregnancy and labor. Results. All the patients could carry out the PAMG-1 test without any assistance and interpret its result. The sensitivity of the PAMG-1 test was 97.3%; its specificity was 97.1%; the prognostic value of positive and negative results was 98.3 and 94.3%, respectively. The capabilities of a set of the routine studies were much worse: 68.5% sensitivity, 74.3% specificity; the prognostic value of the results was 84 and 44.1%, respectively. The PAMG-1 test failed to diagnose ruptured membranes in 34% of the women despite their complaints and clinical findings, but confirmed premature amniorrhea in 22 of 50 women with negative results yielded by a set of the routine methods. Conclusion. The PAMG-1 test is a simple and accurate diagnostic method for ruptured fetal membranes, which may be effectively used in both the inpatient and outpatient settings. The fact that the patients can use the test without any assistance will allow them to be timely referred to a hospital, which will reduce the risk of complications. The negative test result will be able to avoid unnecessary admissions and medical interventions.

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About the authors

Oleg R Baev

Academician V.I. Kulakov Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia

Email: metod_obsgyn@hotmail.com
PHD, MD, Head of Maternity Department 117997, Russia, Moscow, Ac. Oparina str. 4

Oksana N Vasilchenko

Academician V.I. Kulakov Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia

Email: vasilchenko-on@mail.ru
PHD, the senior researcher of Maternity Department 117997, Russia, Moscow, Ac. Oparina str. 4

Valentina P Rumyantseva

Academician V.I. Kulakov Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia

Email: valya-ru@yandex.ru
PHD, Junior Researcher of Maternity Department 117997, Russia, Moscow, Ac. Oparina str. 4

Azaliya B Shahmaeva

Academician V.I. Kulakov Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia

Email: a.shahmaeva@mail.ru
PHD, the doctor of Maternity Department 117997, Russia, Moscow, Ac. Oparina str. 4

Olga A Kozlova

Postgraduate Medical Education I.M. Sechenov First Moscow State Medical University

Email: olgandrevna@mail.ru
Postgraduate student, Department of Obstetrics, Gynecology, Reproduction and Perinatology, Faculty 119991, Russia, Moscow, Trubetskaya str. 8 bld. 2

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