CLINICAL AND ECONOMIC EFFECTIVENESS OF A PLACENTAL a-MICROGLOBULIN-1 TEST AND THAT OF THE CLINICAL DIAGNOSIS OF PREMATURE RUPTURE OF MEMBRANES


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Abstract

The incidence of premature rupture of membranes (PROM) during full-term and preterm pregnancy is 10 and 40%, respectively. To clarify the diagnosis of PROM in clinical practice, tests are used, which have a high frequency of false-positive results, being accompanied by unreasonable economic costs. At the same time, new biochemical markers of high accuracy have been developed. Objective: to compare the clinical and economic efficacy of traditional clinical examination and a placental alpha-microglobulin-1 (PAMG-1) test in patients with a presumptive diagnosis of PROM. Subjects and methods. The investigation enrolled 114 women with a presumptive diagnosis of PROM. A decisionmaking model was developed and the cost-effectiveness of traditional tactics and the PAMG-1 test were compared. Results. The cost of a case with the traditional survey strategy was 16,700 rubles. That of the PAMG-1 test was 3,000 rubles. The average cost of a case when using the latter was 3,060 rubles. The average cost saving per patient was 13,640 rubles. Conclusion. Compared with the traditional approach to diagnosing PROM, the use of the PAMG-1 test is more effective and cost-effective.

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About the authors

Oleg R. Baev

Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia; I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia

Email: metod_obsgyn@hotmail.com
MD; Head, Maternity Department One; Department of Obstetrics, Gynecology, and Reproductology 4, Academician Oparin Street, Build. 1, Moscow 117513, Russia

Oleg V. Tysyachnyi

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

Email: olti23@mail.ru
Cand. Med. Sci.; Researcher, Department of Innovative Technologies 4, Academician Oparin St., Build. 1, Moscow 117513, Russia

Vladimir A. Klimov

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

Email: va_klimov@oparina4.ru
Cand. Med. Sci.; Head, Service for Organization of Medical Care and Information Service 4, Academician Oparin St., Build. 1, Moscow 117513, Russia

Ivan S. Balashov

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

Email: i_balashov@oparina4.ru
Junior Researcher Laboratory of Bioinformatics 4, Academician Oparin St., Build. 1, Moscow 117513, Russia

References

  1. Negara K.S., Prajawati N.L.L.C., Surya G.P., Suhendro S., Arijana K., Tunas K. Protein 53 (P53) expressions and apoptotic index of amniotic membrane cells in the premature rupture of membranes. Open Access Maced. J. Med. Sci. 2018; 6(11): 1986-92. https://doi.org/10.3889/oamjms.2018.465.
  2. Ocviyanti D., Wahono W.T. Risk factors for neonatal sepsis in pregnant women with premature rupture of the membrane. J Pregnancy. 2018; 2018: 4823404. https://doi.org/10.1155/2018/4823404. eCollection 2018.
  3. Ibishi V.A., Isjanovska R.D. Prelabour rupture of membranes: mode of delivery and outcome. Open Access Maced. J. Med. Sci. 2015; 3(2): 237-40. https://doi. org/10.3889/oamjms.2015.037.
  4. Gallot D. Diagnosis of rupture of fetal membranes: CNGOF Preterm Premature Rupture of Membranes Guidelines. Gynecol. Obstet. Fertil. Senol. 2018; 46(12): 1022-8. https://doi.org/10.1016/j.gofs.2018.10.014.
  5. Mariona F.G., Cabero L. Are we ready for a new look at the diagnosis of premature rupture of membranes? J. Matern. Fetal Neonatal Med. 2012; 25(4): 403-7. https://doi.org/10.3109/14767058.2011.581715.
  6. Lee S.M., Lee J., Seong H.S., Lee S.E., Park J.S., Romero R., Yoon B.H. The clinical significance of a positive Amnisure test in women with term labor with intact membranes. J. Matern Fetal Neonatal Med. 2009; 22(4): 305-10.
  7. Abdelazim I.A., Abdelrazak K.M., Al-Kadi M., Yehia A.H., Abdulkareem A.F. Fetal fibronectin (Quick Check fFN test) versus placental alpha microglobulin-1 (AmniSure test) for detection of premature rupture of fetal membranes. Arch. Gynecol. Obstet. 2014; 290(3): 457-64. https://doi.org/10.1007/s00404-014-3225-5.
  8. Di Renzo G.C., Roura L.C., Facchinetti F., Antsaklis A., Breborowicz G., Gratacos E. et al. Guidelines for the management of spontaneous preterm labor: identification of spontaneous preterm labor, diagnosis of preterm premature rupture of membranes, and preventive tools for preterm birth. J. Matern. Fetal Neonatal Med. 2011; 24(5): 659-67.
  9. Echebiri N.C., McDoom M.M., Pullen J.A., Aalto M.M., Patel N.N., Doyle N.M. Placental alpha-microglobulin-1 and combined traditional diagnostic test: a cost-benefit analysis. Am. J. Obstet. Gynecol. 2015; 212(1): 77. e1-10. https:// doi.org/10.1016/j.ajog.2014.07.028.

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