Insulin-Like Growth Factor Binding Protein-I; a Rapid Detection of Amniotic Fluid Leakage after Amniocentesis

The aim of this study was to assess the diagnostic value of vaginal insulin-like growth factor binding protein-1 (IGFBP-I)in the detection of amniotic fluid leakage after amniocentesis.It includes 58 healthy pregnant women who successfully underwent amniocentesis at 15-20 weeks of gestation. After amniocentesispatients were evaluated for amniotic fluid leakage at 60 min, 48 h, and 6 weeks after the procedure with speculum examination,nitrazine paper test and microscopic evidence of ferning, and were grouped into Group I (at least 2 positive tests) and Group II(others) according to the first evaluation. All patients tested for vaginal IGFBP-I.A total of 1.1% (7/58) of patients met the Group I criteria. Vaginal bleeding and contraction occurrence was nonsignificantly higherin Group I. One false positive and one false negative result were obtained from IGFBP-I testing. The sensitivity of this test was 85%,specificity was 98%, positive predictive value (PPV) was 85% and negative predictive value (NPV) was 98%. After 48 h thesensitivity of this test was 75%, specificity was 98%, PPV was 75% and NPV was 98%. Results at the 6th week were similar tothose at 48 h.In conclusion the detection of vaginal IGFBP-I is highly predictive for amniotic fluid leakage especially in clinically doubtful cases