Utilidad de la proteína de unión al factor de crecimiento similar a la insulina tipo 1 en la ruptura prematura de membrana

Miguel Ruoti Cosp, Mario Villalba E

Resumen


Introducción: Frecuentemente no disponemos de una clara evidencia de la pérdida de líquido amniótico observado por examen con espéculo, por lo que el diagnóstico de rotura prematura de membranas puede ser con frecuencia incierto, por lo que se necesitan pruebas de diagnóstico apropiadas y complementarias para la toma de decisiones. Objetivo: conocer la precisión diagnóstica de la proteína-1 de unión al factor de crecimiento similar a la insulina (IGFBP-1) en la rotura prematura de membranas al compararla con la medición del bolsilla mayor por ecografía y el Test de de Ferning. Material y métodos: 102 gestantes de 24 a 37 semanas con signos y/o síntomas de rotura de membranas fueron elegibles, fueron evaluadas con las pruebas IGFBP-1, ecografía y Test de Ferning. Resultados: Para el IGFBP-1 se obtuvo 95% de sensibilidad (S), 95% de especificidad (E), 95% de valor predictivo positivo (VPP) y 96% de valor predictivo negativo (VPN). Par el Test de Fernig se obtuvieron valores de 85%, 25%, 25% y 83% respectivamente. En tanto que para la ecografía los hallazgos fueron de 81%, 29%, 56% y 58% respectivamente. Conclusión: el ensayo IGFBP-1 fue el método más preciso para diagnosticar la ruptura prematura de membranas con la mayor sensibilidad, especificidad, valor predictivo positivo y valor predictivo negativo.

Palabras clave


proteína de unión a factor de crecimiento insulínico-1; prueba de Ferning; mediaciones de ecografía; embarazo; ruptura prematura de membranas

Texto completo:

PDF

Referencias


Prelabor rupture of membranes. ACOG Practice Bulletin No. 188. American College of Obstetricians and Gynecologists. Obstet Gynecol 2018;131:e1–14.

Waters TP, Mercer B. Preterm PROM: prediction, pre- vention, principles. Clin Obstet Gynecol 2011;54:307-12.

Ananth CV, Oyelese Y, Srinivas N, Yeo L, Vintzileos AM. Preterm premature rupture of membranes, intrauterine infection, and

oligohydramnios: risk factors for placental abruption. Obstet Gynecol. 2004;104(1):71–77.

Ananth CV, Savitz DA, Williams MA. Placental abruption and its association with hypertension and prolonged rupture of membranes: a methodologic review and meta-analysis. Obstet Gynecol. 1996;88:309–318.

Echebiri N. Placental alpha-microglobulin-1 test in resource-limited settings: A cost-effectiveness analysis. Obstet Gynecol. 2016;127(3):584-91.

Akercan F, Cirpan T, Kazandi M, Terek MC, Mgoyi L, Ozkinay E. The value of the insulin-like growth factor binding protein-1 in the cervical-vaginal secretion detected by immunochromatographic dipstick test in the prediction of delivery in women with clinically unconfirmed preterm premature rupture of membranes. Eur J Obstet Gynecol Reprod Biol 2005;121:159-63.

Reece EA, Wiznitzer A, Le E, Homko CJ, Behrman H, Spenncer EM. The relation between human fetal growth and fetal blood levels of insulin-like growth factors I and II, their binding proteins, and receptors. Obstet Gynecol. 1994;84:88–95.

Mohan S, Baylink DJ. IGF-binding proteins are multifunctional and act via IGF-dependent and -independent mechanisms. J Endocrinol 2002;175:19–31.

Martina NA, Kim E, Chitkara U, Wathen NC, Chand T, Giudice LC. Gestational age-dependent expression of insulin-like growth factor binding protein (IGFBP-I) phospho-forms in human extra-amniotic cavities, maternal serum, and decidua suggests decidua as the primary source of IGFBP-I in these fluids during early pregnancy. J Clin Endocrinol Metab 1997;82:1894–8.

Palacio M, Kühnert M, Berger R, Larios CL, Marcellin L. Meta-analysis of studies on biochemical marker tests for the diagnosis of premature rupture of membranes: comparison of performance indexes. BMC Pregnancy Childbirth. 2014;14:183.

Ramírez-Martínez JJ, Soria-López JA, Ambriz López R, Iglesias-Benavides JL. Comparación entre dos pruebas diagnósticas de rotura prematura de membrana. Ginecol Obstet Mex 2012;80(3):195-200.

Nabhan AF, Elhelaly A, Elkadi M. Antibiotic prophylaxis in prelabor spontaneous rupture of fetal membranes at or beyond 36 weeks of pregnancy. Int J Gynaecol Obstet. 2014;124(1):59-62.

Begum J, Samal SK, Ghose S, Niranjan G. Vaginal fluid urea and creatinine in the diagnosis of premature rupture of membranes in resource limited community settings. J Family Reprod Health. 2017;11(1): 43-49.

Wang T, Zhou R, Xiong W, Wang Y, Zhu C, Song C, et al. Clinical evaluation of soluble intercellular adhesion molecule-1 and insulin like growth factor-binding protein-1-based rapid immunoassays for the diagnosis of prelabor rupture of membranes. J Perinat Med. 2013;41(2):181-5.

Igbinosa I, Moore FA 3rd, Johnson C, Block JE. Comparison of rapid immunoassays for rupture of fetal membranes. BMC Pregnancy Childbirth. 2017;17(1):128.

Van der Ham DP1, van Teeffelen AS, Mol BW. Prelabour rupture of membranes: overview of diagnostic methods. Curr Opin Obstet Gynecol. 2012;24(6):408-12.

Kariman N, Hedayati M, Alavi Majd Sh. The diagnostic power of cervico-vaginal fluid prolactin in the diagnosis of premature rupture of membranes. Iran Red Crescent Med J. 2012;14(9):541-8.

Tian CF, Lv FH, Wang M, Gu XS. Serum β-human chorionic gonadotropin and interleukin-1 as diagnostic biomarkers for the premature rupture of membranes and chorioamnionitis. Biomed Rep. 2014 Nov;2(6):905-909.

Ghasemi M, Jaami R, Alleyassin A, Ansarimoghaddam A. The value of urea, creatinine, prolactin, and beta sub-unit of human chorionic gonadotropin of vaginal

fluid in the diagnosis of premature preterm rupture of membranes in pregnancy. Turk J Obstet Gynecol. 2016;13(2):62-66.

Erdemoglu E, Mungan T. Significance of detecting insulin-like growth factor binding protein-1 in cervicovaginal secretions: comparison with nitrazine test and amniotic fluid volume assessment. Acta Obstet Gynecol Scand. 2004;83:622–6.

Balić D, Latifagić A, Hudić I. Insulin-like growth factor-binding protein-1 (IGFBP-1) in cervical secretions as a predictor of preterm delivery. J Matern Fetal Neonatal Med. 2008;21(5):297-300.

Tanir HM1, Sener T, Yildiz Z. Cervical phosphorylated insulin-like growth factor binding protein-1 for the prediction of preterm delivery in symptomatic cases with intact membranes. J Obstet Gynaecol Res. 2009;35(1):66-72.

Liang DK, Qi HB, Luo X, Xiao XQ, Jia XY. Comparative study of placental α-microglobulin-1, insulin-like growth factor binding protein-1 and nitrazine test to diagnose premature rupture of membranes: a randomized controlled trial. J Obstet Gynaecol Res. 2014;40(6):1555-60.

Tagore S, Kwek K. Comparative analysis of insulin-like growth factor binding protein-1 (IGFBP-1), placental alpha-microglobulin-1 (PAMG-1) and nitrazine test to diagnose premature rupture of membranes in pregnancy. J Perinat Med. 2010;38(6):609-12.

1 Abdelazim IA. Insulin-like growth factor binding protein-1 (Actim PROM test) for detection of premature rupture of fetal membranes. J Obstet Gynaecol Res. 2014;40(4):961-7.

Ramsauer B, Duwe W, Schlehe B, Pitts R, Wagner D, Wutkewicz K, et al. Effect of blood on ROM diagnosis accuracy of PAMG-1 and IGFBP-1 detecting rapid tests. J Perinat Med. 2015;43(4):417-22.


Enlaces refback

  • No hay ningún enlace refback.


 

Creative Commons License Todo el contenido de esta revista, excepto dónde está identificado, está bajo una Licencia Creative Commons

---------------------------------------------------------------------------------------------

Facultad de Ciencias Médicas. Universidad Nacional de Asunción

Capitan Miranda e/ Río de la Plata y Dr. Montero
(Edificio Ex-Semiología Médica)
C.P. 1120 Asunción - Paraguay



Contadores de visitas gratis para webCursosContadores de visitas gratis para web