Productdescription
RuptureoffetalmembranesthatoccursbeforetheonsetoflaborisknownasPrematureRuptureofMembranesorPROM.PROMoccursrelativelyfrequentandconcerns5to10%ofpregnancycases.Itmightleadtofetalinfectionandpretermdelivery.AppropriatemanagementofPROMisimportanttoreducetheconsequencestoneonatalhealth.TheleakageofamnioticliquidisnotalwaysdetectablebyconventionalclinicalexaminationandthereforeconfirmatoryBIOLOGicaltestcanbeveryuseful.Biologicaltestsarebasedondetectionofalkalinisationofvaginalfluid(easytoproceed,sensitiveandinexpensive,butpoorlyspecific)orpresenceofamoleculewhichisphysiologicallypresentinhighconcentrationinamnioticfluidsuchasinsulin-likegrowthfactorbindingprotein-1(IGFBP-1).
IGFBP-1,alsoknownasplacentalprotein12(PP12)isthemajorinsulin-likegrowthfactorbindingproteinintheamnioticfluid,whichgraduallyincreasesinthesecondtrimesterandremainshigherthroughoutpregnancyincomparisontoitsplasmalevels.Itsconcentrationinamnioticfluidis100–1000timeshigherthantheconcentrationinotherbodilyfluids.IGFBP-1phosphorylatedisoformismainlysecretedinthedeciduacellsandhumanliver,whereasthenon-phosphorylatedisoformismainlyfoundintheamnioticfluid.DetectionofIGFBP-1inthecervical–vaginalsecretionshasbeenshowntobeareliablemethodinthediagnosisofrupturedamnioticmembraneincasesinwhichtheclinicaldiagnosisisuncertain3.