Comparative analysis of insulin-like growth factor binding protein-1 (IGFBP-1), placental alpha-microglobulin-1 (PAMG-1) and nitrazine test to diagnose premature rupture of membranes in pregnancy.

to compare insulin-like growth factor binding protein-1 (IGFBP-1) (non-phosphorylated), placental alpha-microglobulin-1 (PAMG-1) and nitrazine test to diagnose premature rupture of membrane to allow gestation-specific management. we recruited 100 women with signs or symptoms of premature rupture of membranes (PROM), between 17 and 37 weeks at a tertiary referral center. in 100 women in whom PAMG-1 was performed, sensitivity was 92.7%, specificity was 100%, positive predictive value (PPV) was 100% and negative predictive value (NPV) was 95.2%. IGFBP-1 was performed in 94 women, the sensitivity was 87.5%, specificity was 94.4%, PPV was 92.1% and NPV was 91.1%. In 98 women in whom nitrazine test was performed, the sensitivity was 85%, specificity was 39.7%, PPV was 49.3% and NPV was 79.3%. PAMG-1 was the most accurate test in diagnosing rupture of membranes and had the highest sensitivity, specificity, PPVs and NPVs.