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Journal of Perinatal Medicine

Official Journal of the World Association of Perinatal Medicine

Editor-in-Chief: Dudenhausen, MD, FRCOG, Joachim W.

Ed. by Bancalari, Eduardo / Chappelle, Joseph / Chervenak, Frank A. / D'Addario , Vincenzo / Genc, Mehmet R. / Greenough, Anne / Grunebaum, Amos / Konje, Justin C. / Kurjak M.D., Asim / Romero, Roberto / Zalud, MD PhD, Ivica

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Volume 43, Issue 4


Effect of blood on ROM diagnosis accuracy of PAMG-1 and IGFBP-1 detecting rapid tests

Babett Ramsauer / Wiebke Duwe / Bettina Schlehe / Regina Pitts / Dirk Wagner / Katja Wutkewicz / Dmitry Chuvashkin / Harald Abele / Robert Lachmann
Published Online: 2014-11-08 | DOI: https://doi.org/10.1515/jpm-2014-0227


Vaginal bleeding may be present in up to 30% of patients presenting with signs and symptoms of a rupture of the fetal membranes (ROM). The presence of blood may lead to false positive results with biochemical markers. The data presented in this study came from a multi-centric prospective observational clinical study that, for the first time, systematically evaluated the performance of placental alpha microglobulin-1 (PAMG-1) and insulin-like growth factor binding protein-1 (IGFBP-1) detecting tests in 151 women with vaginal bleedings as well as signs and symptoms indicative of ROM. Our data showed better performance for the PAMG-1 compared with the IGFBP-1 detecting tests in all quality parameters evaluated. In detail, sensitivity (SN) was 97.8% (91.0%), specificity (SP) was 91.5% (75.0%), positive predictive value (PPV) was 94.6% (83.5%) and negative predictive value (NPV) was 96.4% (85.7%) for PAMG-1 tests (and IGFBP-1 tests, respectively). A major difference between both tests was related to the number of non-evaluable test results (e.g., hidden bands due to blood smear on the test strips). While 2% of all results were not evaluable for PAMG-1 tests, this artifact appeared in 11% of the results obtained with IGFBP-1 tests. This difference and also those in Specificity and PPV were statistically significant, demonstrating superiority of PAMG-1 over IGFBP-1 detecting tests. In conclusion, the PAMG-1 detecting test was significantly less susceptible to interference by blood than the IGFBP-1 detecting test.

Keywords: Actim PROM; AmniSure; IGFBP-1 (insulin-like growth factor binding protein-1); PAMG-1 (placental alpha-microglobulin-1); premature rupture of fetal membranes (PROM); uncertain rupture; vaginal bleeding


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About the article

Corresponding author: Babett Ramsauer, Vivantes Klinikum Neukölln – Perinatal Medicine Rudowerstr. 48 Berlin 12351, Germany, Tel.: +004930130148486, Fax: 004930130148599, E-mail:

Received: 2014-07-09

Accepted: 2014-09-15

Published Online: 2014-11-08

Published in Print: 2015-07-01

Citation Information: Journal of Perinatal Medicine, Volume 43, Issue 4, Pages 417–422, ISSN (Online) 1619-3997, ISSN (Print) 0300-5577, DOI: https://doi.org/10.1515/jpm-2014-0227.

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