Gaucherand P, Guibaud S, Rudigoz R C, Wong A
Gynecological and Obstetrics Service, Hopital de la Croix Rousse, Lyon, France.
Acta Obstet Gynecol Scand. 1994 Jul;73(6):456-9. doi: 10.3109/00016349409013430.
Premature rupture of membranes (PROM) is sometimes difficult to diagnose. This report proposes the use of alpha-feto-protein (AFP) values in vaginal secretions for diagnostic tests. Our investigation took place in two separate phases. The first phase validated the AFP test using an immuno-enzymatic assay method and determined a threshold value from a sample of 167 female patients (Group 1: 133 patients with an extremely low probability of PROM, and Group 2: 54 patients with confirmed PROM). In the second phase the test was applied to a sample of 145 female patients (Group 3) with suspected, but unconfirmed, PROM. Results from alpha-feto-protein (AFP) evaluation were compared with data obtained from clinical, echographic and other tests. The positive/negative threshold adopted was an AFP concentration of 30 micrograms/l. For the two first groups, 1 and 2, sensitivity and specificity was in the 98% to 99% confidence level. For Group 3, sensitivity and specificity results at the 30 micrograms/l threshold value were 94.5% and 95.4% respectively. Quantitative measurement of AFP determined by immuno-enzymatic assay of vaginal secretions with a threshold of 30 micrograms/l is a reliable, simple and rapid diagnostic test. Results obtained are significantly better than the measurement of pH, the determination of prolactin, and more practical than diamino-oxidase (DAO) assays.
胎膜早破（PROM）有时难以诊断。本报告提出将阴道分泌物中的甲胎蛋白（AFP）值用于诊断测试。我们的调查分两个阶段进行。第一阶段使用免疫酶测定法验证AFP测试，并从167名女性患者样本中确定阈值（第1组：133名PROM可能性极低的患者，第2组：54名确诊为PROM的患者）。在第二阶段，该测试应用于145名疑似但未确诊PROM的女性患者样本（第3组）。将甲胎蛋白（AFP）评估结果与从临床、超声检查和其他测试中获得的数据进行比较。采用的阳性/阴性阈值为AFP浓度30微克/升。对于前两组，即第1组和第2组，敏感性和特异性在98%至99%的置信水平。对于第3组，在30微克/升阈值时的敏感性和特异性结果分别为94.5%和95.4%。通过免疫酶法对阴道分泌物进行AFP定量测量，阈值为30微克/升，是一种可靠、简单且快速的诊断测试。所获得的结果明显优于pH测量、催乳素测定，并且比二胺氧化酶（DAO）测定更实用。
