Prediction of Delivery in Women with Threatening Preterm Labour using Phosphorylated Insulin-Like Growth Factor Binding Protein-1 and Cervical Length using Transvaginal Ultrasound
Journal Title: Journal of Clinical and Diagnostic Research - Year 2017, Vol 11, Issue 9
Abstract
Introduction: Preterm delivery remains a challenge in Obstetrics as it is responsible for significant cause of perinatal morbidity and mortality. At present there is no standard test for prediction of preterm labour for timely referral to a center with NICU facilities. Aim: To evaluate the effectiveness of the cervical phosphorylated insulin like growth factor binding protein-1(phIGFBP-1), cervical length measurement and combination of phIGFBP-1 with cervical length for Predicting Preterm Labour (PTL). Materials and Methods: It was a observational prospective study done from January 2014 to April 2015 in Department of Obstetrics and Gynaecology, NDMC Medical College and Hindu Rao Hospital, Delhi, India. A total of 100 women with singleton pregnancy, between 24 and 36 weeks of gestation with complaint of uterine contractions were randomly selected. These women were subjected to detect phIGFBP-1 in cervical secretions and cervical length measurement by Transvaginal Sonography (TVS). Result of the test, cervical length and time lapse between test and delivery was noted and the results were analysed. The cervical length less than 25 mm was used as a cut off point for predicting pre-term delivery. Data was analysed using SPSS software version 20.0. Results: The Negative Predictive Value (NPV) of phIGFBP-1 and cervical length was similar (95.2% vs 94.05%) respectively for prediction of preterm labour within one week of admission and 93.92% vs 94.80% at 37 weeks of gestational age. Combined test had higher NPV of 96.38% at 34 weeks of gestation and 94% within two days of admission. Positive Predictive Value (PPV) was low for both the test and combining the two-test did not have any advantage as far as PPV was concerned. Receiver Operating Characteristic (ROC) curve showed that the combined test had a superior result in predicting PTL compared to either phIGFBP-1 or cervical length. The combined test had steepest ROC curve at < 34 weeks of gestation (AUC-0.83 with 95% CI). Conclusion: The phIGFBP-1 test and cervical length have an almost equivalent ability to predict preterm delivery independently. The combined use of phIGFBP-1 and TVS for cervical length shows an increase in efficacy in predicting preterm labour.
Authors and Affiliations
Amrita Kumari, Vandana Saini, P. K. Jain, Mamta Gupta
Keywords
Related Articles
- EP ID EP363418
- DOI 10.7860/JCDR/2017/28794.10585
- Views 82
- Downloads 0
Clinical Evaluation of Efficacy and Performance of All-Poly Tibial Freedom® Total Knee System for Treating Osteoarthritis Patients: Three-Year Follow Up Study
Introduction: Advancement in technology in terms of design and building materials has made Total Knee Replacement (TKR) a highly effective, safe, and predictable orthopedic procedure. Aim: To review the clinical outcomes...
Amnion and Chorion Membranes in the Treatment of Gingival Recession and their Effect on Gingival Biotype: A Clinical and Ultrasonographic Study
ABSTRACT Introduction: Treatment of gingival recession defects should aim at addressing both the biological and aesthetic demands. The chances of relapse are minimised if periodontal therapy fulfils the main goal to atta...
Protective Impact of Fruits and Vegetable Intake on Cardiovascular Risk Factors-A Review
ABSTRACT Consumption of fruits and vegetables is essential for maintaining good health and the longevity, as they are rich in vitamins, minerals, dietary fiber, and phytochemicals. High consumption of fruit and vegetable...
Pigmented Villonodular Synovitis of Thumb-A Cytological Diagnosis
Pigmented Villonodular Synovitis (PVNS) is a unique benign proliferative process of unknown aetiology involving the synovial lined joints diffusely or focally. The entity remains a diagnostic challenge. This condition is...
Comparison of the Sealing Ability of MTA-Angelus, Biodentine and CEM Cement in the Repair of Large Furcal Perforations-A Bacterial Leakage Study
ABSTRACT Introduction: Materials such as MTA-Angelus, Biodentine, and CEM Cement have been recommended for the repair of large furcal perforations. Due to larger surface area of such perforations, evaluating the sealing...