Alpha-Foetoprotein in the Diagnosis of Prelabour Rupture of Membranes

Abstract

Content: Prelabour rupture of membranes (PROM) complicates overall 10% of gestations which include 7% at term and 3 % preterm gestations. Making an early and accurate diagnosis of PROM is important, to allow gestational age specific obstetric interventions and to optimize perinatal outcome. Objective: To study the efficacy of alpha-foeto protein in cervicovaginal secretions, to diagnose prelabour rupture of membranes. Setting: A tertiary care centre. Materials and Methods: We performed a prospective study on 130 patients who were at ≥ 24 weeks of gestation, who had complaint of leaking per vagina, between September 2011 and August 2013. Alpha-foetoprotein test was perfomed on cervicovaginal secretions which were collected during perspeculum examinations. A diagnosis of prelabour rupture of membranes was made, based on combined clinical diagnosis which was made during hospital stay of the patients prospectively. The efficacy of Alpha-foetoprotein was studied. Stastical Analysis: Chi-square test, Kappa analysis. Results: The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of Alpha-foetoprotein were 88.9%, 98.5%, 98.3%, 90.1% and 93.8% respectively. Degree of agreement of Alpha-foetoprotein with combined clinical diagnosis was 0.875. Conclusion: Assessment of alpha-foetoprotein levels in cervicovaginal secretions can be used as a reliable test to diagnose prelabour rupture of membranes when faced with a diagnostic dilemma.

Keywords

• alpha-foetoprotein
• prelabour rupture of membranes
• combined clinical diagnosis