Diagnostic value of beta-HCG versus placental alpha microglobulin-1 in the diagnosis of prelabour rupture of membranes in an Urban Hospital Population
DOI:
https://doi.org/10.5281/acs.v10i1.201Abstract
Background: Prelabour Rupture of Membranes (PROM) is a global health challenge imposing a great risk to both the mother and the foetus The diagnosis of PROM can be challenging in instances where there is no obvious leakage of fluid from the cervix. Although some tests have been documented to have high diagnostic accuracy, there is as yet a universally accepted "gold standard" diagnostic test. This study aimed to assess the diagnostic value of the qualitative detection of beta human chorionic gonadotropin (HCG) in cervicovaginal fluid in PROM and to compare its accuracy with the immunoassay of placental alpha microglobulin-1 (PAMG-1).
Methodology: This comparative analytic study involved pregnant women at gestational ages ≥ 28 weeks with suspected PROM. Cervicovaginal β-HCG was assayed qualitatively using a standard pregnancy test strip, while PAMG-1 immunoassay was done with the Amnisure ROM® 2012 kit (International LLC, Boston, USA). The presence of 2 lines (control and test) in either kit was interpreted as positive. It was considered negative if only the control line was present and invalid if no lines were observed. The definitive diagnosis of PROM was made following the review of the case notes for the clinical course and outcomes of each patient.
Results: Among the 136 women examined, 88 tested positive for PAMG-1, while 87 tested positive for β-HCG. The final diagnosis of PROM was made in 90 women. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 97.8%,100%, 100%, 95.8%, 98.5% and 96.7%, 100%, 100%, 93.9%,97.8% for PAMG-1 and β-HCG, respectively. There was no significant difference between the detection ability of both tests (p-value=0.899).
Conclusion: While PAMG-1 may offer slightly higher diagnostic accuracy, β-hCG could be a comparable and more cost-effective alternative, especially considering the context and specific circumstances.
