The Clinical Value Of Vaginal Secretion No Phosphorylation Insulin-like Growth Factor Binding Protein-1 In The Diagnosis Of Premature Rupture Of Membranes Secretiveness Tyres

Objective:To explore the clinical value of insulin-like growth factor binding protein-1 in the vaginal secretions for the diagnosis of premature rupture of membrane (PROM).Methods:A total of 281 pregnant women that were in Xiangya hospital from 2010.03 to 2011.02 were recruited for the study. They were separated into three groups:A group,135 cases of pregnant women diagnosed with premature rupture of membranes; B group,74 cases, including 39 cases of pregnant women that no incentive vaginal secretion discharge or vulva wet,and 35 cases of pregnant women that oligohydramnios or less than normal; C group,72 cases of normal pregnant women that with normal AFI and no vaginal secretion at the same period. All of the women was measured by IGFBP-1 test, PH test and amniotic fluid crystallization test(fern test), and the results were recorded in detail. All data were analyzed using SPSS 13.0 package: the measurement data were recorded in the form ofχ±s; the comparison of two groups were analyzed using t-test; the comparison of the mean between groups were analyzed using variance test; the comparison between any two groups were performed using chi-square partitio-ning method, and the differences were considered to be significant when the value of Pis less than 0.05。Results:1.To A group, as a predictor for the diagnosis of PROM, IGFBP-1 had a sensitivity of 98.5%,a specificity of 97.2%, a positive predictive value of 98.5% and a negative predictive value of 97.2%. the correct index was 99%. Sensitivity,specificity,positive predictive value and negative predictive value of PH test and fern test were as follows:PH test(94.8%,90.3%,94.8% and 90.3%),fern test (95.6%,97.2%,98.5% and 92.1%).2.To B group,the incidence of premature rupture of membrane was 72.9%. Sensitivity,specificity,positive predictive value and negative predictive value of PH test and fern test were as follows: IGFBP-1(94.4%,85.0%,94.4% and 85.0%);PH test(87.0%.,80.0%,92.2% and 69.0%),fern test (83.3%,80.0%,91.8%,64.0%).3.To B group, the misdiagnosis incidence of PH test,fern test and IGFBP-1 was 14.9%,17.5% and 8.0%,respectively.PH test and fern test join detection,the results matct, there were 67.5% of pregnant women diagnosed;the result does not match,32.5% of pregnant women is difficult to diagnose.Conclusion:1. Vaginal secretion no phosphorylation insulin-like growth factor binding protein-1 had more sensitivity,specificity and the correct index than PH test and fern test2. no phosphorylation IGFBP-1can improve the PROM secretiveness tyres diagnosis. PH test and fern test does not match, no phosphorylation IGFBP-1 was theⅡindex.3.No incentive oligohydramnios or less than normal,vaginal secretion discharge or genitalwet may be one of the clinical manifestations of occult PROM.