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The Identification of Placental Alpha Micro Globulin-1(Amnisure®) as a Method to Identify Rupture of Membrane (Deteksi Placental Alpha Micro Globulin-1 (Amnisure®)sebagai Metode dalam Identifikasi Ketuban Pecah

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Objective: We aimed to do a study in the use of the identification of Placental Alpha Micro Globulin-l or PAMG-l, in the form of Amnisure® test, as a method to diagnose rupture of membrane (ROM), compared with other conventional method (direct visualization and nitrazine test).
Method: We used a cross-sectional design. Every pregnant woman who came to our hospital with gestational age of 14 to 42 weeks complaining of membrane rupture was recruited. Sterile speculum examination and nitrazine test was performed for every patient. Amnisure® was utilized, using vaginal swab from posterior fornices. Data analysis was performed with SPSS version 17.
Results: We recruited 20 patients to join our study. Mean age, parity and gestational age was 28.5 years, parity one and 35.5 ± 3.4 weeks of gestation. Amnisure® test was positive in 14 patients. With nitrazine as standard for ROM diagnosis, the sensitivity for Amnisure® was 85% and the specificity was 83.3%. The positive predictive value was 92.3% and negative predictive value was 71.4%.
Conclusion: For every positive vaginal pooling, nitrazine and Amnisure® will be tested positive. Several studies using Amnisure® have shown similar results. Role of Amnisure® seemed evident in cases of uncertainty su ch as chronic ROM and severe oligohydramnios due to ROM. Positive results in presence of intact membranes which suggested micro-perforations of the membrane still need further research. Much still needed to be done before implementing Amnisure® in our country, especially in the matter of cost effectiveness.
Tujuan: Mengadakan penelitian untuk menguji metode deteksi ketuban pecah menggunakan Placental Alpha Micro Globulin-1 (Amnisure®) dibandingkan dengan metode konvensional (tes valsava dan tes lakmus/tes nitrazin).
Metode: Penelitian ini merupakan studi potong lintang. Setiap wanita hamil yang datang ke rumah sakit kami dengan usia gestasi 14 hingga 42 minggu dan keluhan ketuban pecah diikutkan dalam penelitian. Pemeriksaan spekulum steril untuk melihat tes valsava dan tes lakmus dilakukan pada setiap pasien. Tes Amnisure® dilakukan dengan apusan dari forniks posterior. Analisis data dilakukan dengan SPSS versi 17.
Hasil: Sebanyak 20 pasien diikutsertakan dalam studi kami. Rerata usia, paritas dan usia gestasi adalah 28,5 tahun, paritas satu dengan usia gestasi 35,5 ± 3,4 minggu. Tes Amnisure® positif pada 14 pasien. Dengan tes lakmus sebagai standar bagi diagnosis ketuban pecah, sensitivitas Amnisure® adalah 85%, spesifisitas 83,3%. Nilai prediksi positif dan negatif adalah 92,3% dan 71,4%.
Kesimpulan: Untuk setiap tes valsava positif, nilai positif akan di temukan pada tes lakmus dan tes Amnisure®. Beberapa studi menggunakan Amnisure® menunjukkan hasil serupa. Peran Amnisure® tampaknya jelas pada kasus sulit seperti ketuban pecah kronik, oligohidramnion berat karena ketuban pecah. Hasil positif dalam keadaan selaput membran intak, yang menandakan adanya mikro-perforasi memerlukan penelitian tambahan. Studi lebih lanjut diperlukan sebelum mengimplementasikan penggunaan Amnisure® di lndonesia, terutama jika menyangkut isu tentang efektivitas biaya.
Kata Kunci: amnisure®, ketuban pecah, PAMG-1

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Series Title

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Call Number

Indonesian Journal of Obstetrics and Gynecology, 3

Publisher

Jakarta : Indonesian Society of Obstetrics and Gynecology., 2012

Collation

4p

Language

ISBN/ISSN

0303-7924

Classification

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Content Type

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Media Type

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Carrier Type

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Edition

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Subject(s)

pregnancy
RUPTURE
MEMBRANE

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