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Prelabor Rupture Of Membranes At Or Near Term
Published in Vincenzo Berghella, Obstetric Evidence Based Guidelines, 2022
Placental alpha-microglobulin-1 is a 34-kDa glycoprotein abundant in amniotic fluid (2000–25,000 ng/mL); there is a negligible amount of this glycoprotein in vaginal fluid with intact fetal membranes (0.05–2.0 ng/mL) [2, 4, 5]. AmniSure is a bedside immunoassay that uses the delta in concentration of placental alpha-microglobulin-1 for diagnostic accuracy. AmniSure has a sensitivity of 98.7%–98.9% and a specificity of 87.5%–100% [4, 5].
A diagnostic profile on the PartoSure test
Published in Expert Review of Molecular Diagnostics, 2020
Safoura Rouholamin, Maryam Razavi, Mahroo Rezaeinejad, Mahdi Sepidarkish
Placental alpha microglobulin-1 (PAMG-1) is a human glycoprotein that is synthesized by the decidua and isolated in 1975 from amniotic fluid by Dr. Petrunin for the first time. This protein is present in blood, the amniotic fluid, and cervico-vaginal discharge of pregnant women with normal concentration (0.05–0.2 ng/ml). The concentration of PAMG-1 in the cervicovaginal secretions increases several thousand times (2,000–25,000 ng/ml), when the connection between the fetal sac and the uterine lining is disrupted [39]. Nearly 40 previous clinical studies have examined the predictive power of PAMG-1, the majority of which have focused on its ability to detect PROM in non-laboring pregnant women presenting with unexplainable vaginal leakage [40]. But many studies have examined its effectiveness in predicting PTB [41].
Combination of three-dimensional ultrasound measurement of foetal adrenal gland enlargement and placental alpha microglobulin-1 for the prediction of the timing of delivery within seven days in women with threatened preterm labour and preterm labour
Published in Journal of Obstetrics and Gynaecology, 2018
Monchai Santipap, Vorapong Phupong
Placental alpha microglobulin-1 (PAMG-1) is a protein found in high concentrations in amniotic fluid (2000–25,000 ng/mL). Low concentrations can be found in maternal blood (5–25 ng/mL) and in cervicovaginal secretion (0.05–0.2 ng/mL) in the absence of ruptured membranes. In a normal pregnancy, there is foetal amnion and chorion integrity in the second trimester. It is thought that the inflammatory processes associated with impending labour and delivery allow trace levels of PAMG-1 less than those typically associated with the visual presence of amniotic fluid in the vaginal cavity, to pass into the vaginal cavity through microperforations (Sukchaya and Phupong 2013). A developed test kit for PAMG-1 detection has been made available. PartoSure™ test, manufactured by AmniSure International (Boston, MA), is more sensitive in its detection of PAMG-1 1 ng/mL. It is able to detect the patients with signs and symptoms of preterm labour who are at risk for imminent delivery and have no clinical evidence of a membranes rupture. Nikolova et al. reported the PAMG-1 test provided 90.0% sensitivity, 93.8% specificity, 78.3% positive predictive value and 97.4% negative predictive value for the prediction of preterm birth within seven days (Nikolova et al. 2014).
Comparison of placental α microglobulin-1 protein assay (Amnisure) with speculum examination for the diagnosis of premature preterm rupture of membranes (PPROM): a clinical evaluation
Published in Journal of Obstetrics and Gynaecology, 2021
Sertac Esin, Yusuf Aytac Tohma, İsmail Alay, Mahmut Guden, Eser Colak, Nihal Demirel, Ahmet Yagmur Bas, Ethem Serdar Yalvac, Omer Kandemir
Preterm premature rupture of membranes (PPROM) refers to the rupture of membranes (ROM) before 37 weeks gestation (Salman et al. 2019). It is responsible for approximately one third of preterm births (Mercer 2005) and has substantial impact on neonatal mortality and morbidity. Therefore, diagnosis of PPROM is critical for foetal and maternal prognosis. Classically, the diagnosis is established clinically by speculum examination with direct visualisation of amniotic fluid leaking through the cervical canal. However, in 10–20% of patients (Friedman and McElin 1969; Gaucherand et al. 1997; Mercer 2003), the diagnosis of rupture of membranes is difficult especially when the leakage is intermittent and subtle. For those cases, laboratory tests can be used to confirm the presence of membrane rupture. Historically, Nitrazine or fern tests have been used for this purpose however; the results are adversely affected by the presence of infections, semen and blood and therefore, have limited value. Recently, several bedside commercial tests such as placental alpha microglobulin-1 protein assay (PAMG-1) (Amnisure), insulin-like growth factor binding protein 1 (IGFBP-1 [Actim PROM]) and placental protein 12 and alpha-fetoprotein (ROM Plus) have been developed for the diagnosis of ROM. Placental alpha microglobulin-1 protein assay uses immunochromatography method to detect trace amount of placental alpha microglobulin-1 protein in vaginal fluids and has high sensitivity and specificity for ROM diagnosis (Marcellin et al. 2011; Abdelazim and Makhlouf 2012; Birkenmaier et al. 2012; Abdelazim et al. 2014; Mariona and Roura 2016). However, to the best of our knowledge, the clinical outcome of ROM cases detected by classical speculum examination and by placental alpha microglobulin-1 protein assay has not been compared in the literature previously.