Open AccessUsefulness of the insulin‐like growth factor binding protein‐1 bedside test for ruptured fetal membranes
Author(s) -
Kallioniemi Hanna,
Rahkonen Leena,
Heikinheimo Oskari,
Stefanovic Vedran,
Paavonen Jorma
Publication year - 2014
Publication title -
acta obstetricia et gynecologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.401
H-Index - 102
eISSN - 1600-0412
pISSN - 0001-6349
DOI - 10.1111/aogs.12481
Subject(s) - medicine , dipstick , vaginal bleeding , cervix , obstetrics , insulin like growth factor binding protein , amniotic fluid , pregnancy , gynecology , fetus , insulin like growth factor , growth factor , urine , cancer , receptor , biology , genetics
Objective We evaluated whether phosphorylated insulin‐like growth factor binding protein‐1 (ph IGFBP ‐1) in blood or from other sources interferes with the vaginal IGFBP ‐1 dipstick test in rupture of fetal membranes ( ROM ). Design Cross‐sectional study. Setting Antenatal Clinic, University Hospital. Population A total of 247 pregnant women consulting the emergency obstetric unit with self‐reported amniotic fluid leakage. Methods Vaginal samples were tested with the IGFBP ‐1 dipstick test and the concentrations of different IGFBP ‐1 isoforms were measured by two immunoenzymometric assays. Main outcome measure IGFBP ‐1 dipstick test result in the presence or absence of blood and different phosphoisoforms of IGFBP ‐1. Results The dipstick test was positive in 37.2% of women and negative in 62.8% of women. Vaginal bleeding was present in 19.4%. In women with a positive test and clinical evidence of ROM , both IGFBP ‐1 and ph IGFBP ‐1 concentrations in vaginal fluid were lower in women with than in women without bleeding ( p = 0.025 and p = 0.031, respectively). No difference was found in concentrations of IGFBP ‐1 and ph IGFBP ‐1 in women with a positive dipstick test without ROM , with or without vaginal bleeding. In women with a negative test the concentrations of IGFBP ‐1 and ph IGFBP ‐1 remained below the cut‐off for the test, regardless of bleeding. IGFBP ‐1 concentration did not differ by cervical status, but ph IGFBP ‐1 concentration was higher in women with a ripe cervix ( p = 0.001). Conclusions Rapid vaginal dipstick test can be used in the detection of ROM irrespective of the presence or absence of blood. Positive tests near term indicate either ROM or leakage of less ph IGFBP ‐1 associated with onset of delivery.