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Is Amnisure® useful in the management of women with prelabour rupture of the membranes?

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Neil, Peter R. L. Wallace, Euan M.
Description	Country affiliation: Australia Author Affiliation: Neil PR ( Department of Obstetrics and Gynaecology, Monash Medical Centre, Victoria Obstetrics and Gynaecology, Southern Health, Melbourne, Australia. peteneil@bigpond.net.au)
Abstract	AIMS: Prelabour rupture of membranes (PROM), whether at term or preterm, can be a difficult diagnosis to confirm. Clinician uncertainty often leads to unnecessary intervention for risk management reasons. Amnisure® is a bedside immunoassay for placental alpha macroglobulin-1 (PAMG-1), which has been shown to have high sensitivity and specificity in the diagnosis of PROM. However, whether the use of Amnisure® alters clinical management remains untested. The objective of this study was to assess the clinical utility of Amnisure®. METHODS: A prospective cohort study of 184 women presenting with a history of PROM to a tertiary maternity hospital. Before and after Amnisure® , the attending clinician assessed and recorded membrane status (PROM or intact), his/her level of confidence in this diagnosis, and the intended management plan. RESULTS: There was clinician uncertainty regarding the diagnosis of PROM in 83 (47%) women. Amnisure® significantly increased clinician confidence and led to a change of intended management in 23 (13%) women. In 33 women presenting with possible preterm PROM, seven thought to have PROM before Amnisure® had a negative test, leading to a change of management in these women. CONCLUSIONS: Amnisure® is clinically useful when the clinician is uncertain about the diagnosis but not useful when the clinician is confident about the diagnosis. The use of Amnisure® in women where the diagnosis is uncertain is likely to significantly change management, including reduced hospitalisation for women with preterm PROM.
File Format	HTM / HTML
ISSN	00048666
Issue Number	6
Volume Number	50
e-ISSN	1479828X
Journal	Australian and New Zealand Journal of Obstetrics and Gynaecology
Language	English
Publisher	Wiley
Publisher Date	2010-12-01
Publisher Place	Australia
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Discipline Obstetrics Discipline Gynecology Fetal Membranes, Premature Rupture Diagnosis Insulin-like Growth Factor Binding Protein 1 Analysis Female Therapy Humans Immunoassay Pregnancy Clinical Trial Journal Article Research Support, Non-u.s. Gov't
Content Type	Text
Resource Type	Article
Subject	Obstetrics and Gynecology

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Comparative study of placental -microglobulin-1, insulin-like growth factor binding protein-1 and nitrazine test to diagnose premature rupture of membranes: a randomized controlled trial.

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Is Amnisure® useful in the management of women with prelabour rupture of the membranes?

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Is Amnisure® useful in the management of women with prelabour rupture of the membranes?