Use of insulin like growth factor binding protein-1 in the diagnosis of ruptured fetal membranes.

Objective: The benefit of insulin like growth factor binding protein-1 (IGFBP-1) in diagnosing ruptured fetal membranes in cases in which the diagnosis is clinically doubtful, is investigated.

Design: A total of 83 patients with clinically doubtful rupture of fetal membranes were included, and treated as usual. The clinical diagnosis, the amniotic fluid crystallization test, and IGFBP-1 detection were performed on all patients and compared with the defined gold standard. The sensitivity, specificity, positive predictive value, and negative predictive value of each test were calculated.

Results: In all, 27 patients (33%) had ruptured fetal membranes at the time of inclusion. The clinical diagnosis of the attending obstetrician showed a higher predictive value of both a positive and negative test result than both IGFBP-1 detection, and the amniotic fluid crystallization test.

Conclusions: As the clinical diagnosis showed the highest sensitivity and specificity, IGFBP-1 detection has no additional benefit to ascertain the diagnosis of ruptured fetal membranes in cases in which the diagnosis was clinically doubtful.