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Evaluation of Predictive Value of Placental Alpha Microglobulin-1 Compared to Fetal Fibronectin in Symptomatic Preterm Delivery | ||
| Iraqi Postgraduate Medical Journal | ||
| Article 11, Volume 21, Issue 3, 2022, Pages 318-325 PDF (305.47 K) | ||
| Document Type: Research Paper | ||
| DOI: 10.52573/ipmj.2021.175795 | ||
| Authors | ||
| Gul Umit Abbas Awchi; Ayla Khedher Ghalib | ||
| Medical College - Kirkuk University, Kirkuk – Iraq. | ||
| Abstract | ||
| BACKGROUND: Placental alpha microglobulin-1 (PAMG-1) is an important biomarker for the detection of preterm labor and premature rupture of fetal membrane, also fetal fibronectin leak observed into the vagina if a preterm delivery is likely to occur and can be measured by a screening test. OBJECTIVE: To compare the rapid bedside test for (placental alpha microglobulin-1) with the instrumented fetal fibronectin test for prediction of imminent spontaneous preterm delivery among women with symptoms of preterm labor. PATIENT AND METHODS: A prospective observational study, it included 86 pregnant women between 24 – 35 weeks of gestation with singleton pregnancy, viable fetus, intact membrane, and cervical dilatation ≤ 3 cm who attend to the labor room of the hospital complaining from signs and symptoms of spontaneous preterm labor. Patients were tested for placental alpha microglobulin-1 with the instrumented fetal fibronectin test for prediction of imminent spontaneous preterm delivery. RESULTS: The positive predictive values for spontaneous preterm delivery within seven days for placental alpha microglobulin-1and fetal fibronectin were 25% (4/16) and 5.6% (2/36), respectively (P= 0.001 for placental alpha microglobulin-1 superiority), while the negative predictive values were 82.9% (58/70) and 72% (36/50) for placental alpha microglobulin-1 and fetal fibronectin, respectively (P= 0.02 for PAMG-1 superiority). The sensitivity and specificity of placental alpha microglobulin-1 were (25%, and 82.9% respectively), and of fetal fibronectin were (12.5%, and 51.4% respectively). The PPVs for spontaneous preterm delivery within 14 days for placental alpha microglobulin-1 and fetal fibronectin were 43.8% (7/16) and 11.1% (4/36) respectively (P= 0.001 for placental alpha microglobulin-1 superiority), while the NPVs were 81.4% (57/70) and 68% (34/50) for placental alpha microglobulin-1 and FFN, respectively (P= 0.001 for placental alpha microglobulin-1 superiority). The sensitivity and specificity of placental alpha microglobulin-1 were (35%, and 86.4% respectively), and of fetal fibronectin were (20%, and 51.6% respectively). CONCLUSION: Placental alpha microglobulin-1 performed the same as fetal fibronectin in ruling out spontaneous preterm delivery among contemporary cohort of symptomatic women but demonstrated statistical superiority in predicting it. | ||
| Keywords | ||
| spontaneous preterm labor; placental alpha microglobulin-1; fetal fibronectin | ||
| References | ||
10. Berghella V, Hayes E, Visintine J, Baxter JK. Fetal fibronectin testing for reducing the risk of preterm birth. Cochrane Database of Systematic Reviews. 2008.
11. Abbott DS, Radford SK, Seed PT, Tribe RM, Shennan AH. Evaluation of a quantitative fetal fibronectin test for spontaneous preterm birth in symptomatic women. American Journal of Obstetrics and Gynaecology 2013;208:122. e1-6.
12. Goldenberg RL, Culhane JF, Iams JD, Romero R. Epidemiology and causes of preterm birth. The lancet. 2008 Jan 5;371(9606):75-84.
13. World Health Organization. Media Centre. Preterm Birth. http://www. who.int /mediacentre /factsheets/fs363/en/2012.
14. Wing DA, Haeri S, Silber AC, Roth CK, Weiner CP, Echebiri NC, et al. Placental alpha microglobulin-1 compared with fetal fibronectin to predict preterm delivery in symptomatic women. Obstetrics & Gynecology. 2017;130:1183-91.
15. Al-Salami KS, Alyasin ZT, HussainSainn RN. 12-influence of body mass index on the incidence of preterm labour. Basrah Journal of Surgery. 2009;15:72-7.
16. Melchor JC, Navas H, Marcos M, Iza A, De Diego M, Rando D, et al. Predictive performance of PAMG‐1 vs fFN test for risk of spontaneous preterm birth in symptomatic women attending an emergency obstetric unit: retrospective cohort study. Ultrasound in Obstetrics & Gynecology. 2018 ;51:644-49.
17. Nikolova T, Bayev O, Nikolova N, Di Renzo GC. Comparison of a novel test for placental alpha microglobulin-1 with fetal fibronectin and cervical length measurement for the prediction of imminent spontaneous preterm delivery in patients with threatened preterm labor. J Perinat Med 2015;43:395–402.
18. Mausner JS, Kramer S. In Epidemiology: An Introductory Text, Mausner JS, Bahn AK (eds). WB Saunders: Philadelphia, PA, USA, 1985; 221.
19. Boots AB, Sanchez-Ramos L, Bowers DM, Kaunitz AM, Zamora J, Schlattmann P. The short-term prediction of preterm birth: a systematic review and diagnostic metaanalysis. Am J Obstet Gynecol. 2014; 210:54. e1 − 10.
20. Society for Maternal-Fetal Medicine Publications Committee. Progesterone and preterm birth prevention: translating clinical trials data into clinical practice. American journal of obstetrics and gynecology. 2012 1;206(5):376-86.
21. Mariona FG, Roura LC. The role of placental alpha microglobulin-1 amnisure in determining the status of the fetal membranes; its association with preterm birth. Traditions… traditions…. The Journal of Maternal-Fetal & Neonatal Medicine. 2016 18;29:1016-20. | ||
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