The diagnosis of rupture of fetal membranes (ROM): a meta-analysis
| Autor: | Jacques Horovitz, Zulfiya Khodjaeva, Ángel Aguarón de la Cruz, Txantón Martínez-Astorquiza, Babett Ramsauer, Alex C. Vidaeff, Irene Hösli, F. Coatleven, Hanns Helmer, Joong Shin Park, Alexander Strauss |
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| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
Fetal Membranes
Premature Rupture medicine.medical_specialty Population Cervix Uteri Pregnancy Internal medicine medicine Humans Rupture of membranes Clinical significance Diagnostic Errors education education.field_of_study business.industry Obstetrics and Gynecology Odds ratio Amniotic Fluid Surgery Insulin-Like Growth Factor Binding Protein 1 Meta-analysis Vagina Pediatrics Perinatology and Child Health Population study Female Observational study business Biomarkers Cohort study |
| Popis: | Aim: The aim of this study was to compare the performance of tests based on the detection of insulin-like growth factor binding protein 1 (IGFBP-1) and placental α-microglobulin-1 (PAMG-1) in diagnosing rupture of fetal membranes (ROM) across different patient populations. Methods: A meta-analysis was conducted on prospective observational or cohort studies investigating ROM tests based on the detection of IGFBP-1 and PAMG-1 meeting the following criteria: (1) performance metrics calculated by comparing results to an adequate reference method; (2) sensitivity thresholds of the investigated tests matching those of the currently available tests; (3) study population, as a minimum, included patients between 25 and 37 weeks of gestation. Sensitivities, specificities, and diagnostic odds ratios were calculated. Results: Across all patient populations, the analyzed performance measures of the PAMG-1 test were significantly superior compared with those of the IGFBP-1 test. Of particular clinical relevance, PAMG-1 outperformed IGFBP-1 in the equivocal group, which comprised patients with uncertain rupture of membranes (sensitivity, 96.0% vs. 73.9%; specificity, 98.9% vs. 77.8%; PAMG-1 vs. IGFBP-1 tests, respectively). Conclusions: Compared with its performance in women with known membrane status, the accuracy of the IGFBP-1 test decreases significantly when used on patients whose membrane status is unknown. In this latter clinically relevant population, the PAMG-1 test has higher accuracy than the IGFBP-1 test. |
| Databáze: | OpenAIRE |
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