COMPARISON OF TWO RAPID QUALITATIVE ASSAYS (BETA-HUMAN CHORIONIC GONADOTROPIN AND PHOSPHORYLATED INSULIN-LIKE GROWTH FACTOR BINDING PROTEIN-1) FOR PREDICTION OF PRETERM BIRTH IN SYMPTOMATIC WOMEN

Rajeshwari Kumari, Kiran Guleria, Amita Suneja, Neha Gami, Priyanka Meena

Abstract


Introduction: Preterm birth (PTB) it has a major and significant direct and indirect effect on the economy of the nation. The use of various biophysical & biochemical markers have been used for prediction of PTB.

Aim: To compare the two rapid qualitative (QL) assays in cervicovaginal secretions as predictors of preterm birth in symptomatic women.

Methods: 120 women with symptoms and signs of preterm labor (PTL) were recruited and cervicovaginal secretions were collected for qualitative assessment of b-hCG and pIGFBP-1 at admission and subsequently managed as per hospital protocol till delivery.

Results: b-hCG assay was highly specific for predicting preterm birth (PTB) before 37 weeks (sensitivity of 72%, specificity 94.7%, PPV 74.6%, NPV 94%) and more sensitive for predicting PTB before 34 weeks of gestation (sensitivity 89.55%, specificity 35.6%, PPV 88.95%, NPV 37%). The sensitivity, specificity, NPV and PPV for predicting PTB within 48 hours were 86.4%, 81.6%, 91.2% and 73.1%; within 7 days were 83%, 88.1%, 86.8% and 84.6%; and within 14 days were 71.6%, 92.5%, 72.1% and 92.3% respectively.

Conclusion: Both b-hCG and pIGFBP-1 assays were equally accurate (high NPV) in predicting PTB before 37 weeks in symptomatic women. The pIGFBP-1 was better in predicting PTB before 34 weeks, within 48 hours, 7 days & 14 days. βhCG assay may be preferred in low resource countries because of low cost, universal availability and equivalent predictive abilities for PTB in symptomatic women

Keywords


Preterm labour, -hCG, pIGFBP-1, Cervicovaginal secretions

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