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<sec><h3>Background</h3><p>Presence of placental α microglobulin-1 (PAMG-1) in cervicovaginal fluid is a bedside test to predict preterm delivery.</p></sec>
<sec><h3>Objective</h3><p>To determine whether the accuracy of a positive PAMG-1 test result to predict preterm birth within 7 days and 14 days in our hospital setting can be improved by adding cervical length.</p></sec>
<sec><h3>Methods</h3><p>We recruited 180 pregnant women who attended the labor ward of Siriraj Hospital, Thailand, from 2016 to 2018 for this prospective observational study of diagnostic accuracy. We used data from 161 women who met inclusion criteria including symptoms of preterm labor between 20<sup>0/7</sup> and 36<sup>6/7</sup> weeks’ gestation without ruptured membranes and with cervical dilatation &lt;3 cm and effacement &lt;80%. Presence of PAMG-1 in cervicovaginal fluid was tested using a PartoSure kit, cervical length was measured by transvaginal ultrasound, and the time to spontaneous delivery was calculated.</p></sec>
<sec><h3>Results</h3><p>Pregnant women with labor pain who had cervical length &lt;30 mm (45/161; 28%) went into delivery within 7 days, and women with a cervical length &lt;15 mm (11/14; 79%) went into delivery within 7 days. When the PAMG-1 test result was positive and cervical length was ≤15 mm, the positive predictive value (PPV) was 83%; and when cervical length was ≤30 mm the PPV was 69%. The optimal cut off from receiver operating characteristic curve analysis showed that a cervical length &lt;25 mm and PAMG-1 positive result has a PPV of 80% to predict preterm birth within 7 days and 90% within 14 days. The area under the curve (95% confidence interval) for a positive PAMG-1 result and cervical length ≤25 mm to predict preterm birth &lt;7 days was 0.61 (0.50, 0.73) and &lt;14 days was 0.60 (0.49, 0.70).</p></sec>
<sec><h3>Conclusions</h3><p>Cervical length ranging 15–30 mm combined with a positive PAMG-1 test result has a high accuracy to predict imminent spontaneous delivery within 7 days by women with preterm labor and cervical dilatation &lt;3 cm in clinical practice.</p></sec>
</abstract>

BackgroundPresence of placental α microglobulin-1 (PAMG-1) in cervicovaginal fluid is a bedside test to predict preterm delivery.
ObjectiveTo determine whether the accuracy of a positive PAMG-1 test result to predict preterm birth within 7 days and 14 days in our hospital setting can be improved by adding cervical length.
MethodsWe recruited 180 pregnant women who attended the labor ward of Siriraj Hospital, Thailand, from 2016 to 2018 for this prospective observational study of diagnostic accuracy. We used data from 161 women who met inclusion criteria including symptoms of preterm labor between 200/7 and 366/7 weeks’ gestation without ruptured membranes and with cervical dilatation <3 cm and effacement <80%. Presence of PAMG-1 in cervicovaginal fluid was tested using a PartoSure kit, cervical length was measured by transvaginal ultrasound, and the time to spontaneous delivery was calculated.
ResultsPregnant women with labor pain who had cervical length <30 mm (45/161; 28%) went into delivery within 7 days, and women with a cervical length <15 mm (11/14; 79%) went into delivery within 7 days. When the PAMG-1 test result was positive and cervical length was ≤15 mm, the positive predictive value (PPV) was 83%; and when cervical length was ≤30 mm the PPV was 69%. The optimal cut off from receiver operating characteristic curve analysis showed that a cervical length <25 mm and PAMG-1 positive result has a PPV of 80% to predict preterm birth within 7 days and 90% within 14 days. The area under the curve (95% confidence interval) for a positive PAMG-1 result and cervical length ≤25 mm to predict preterm birth <7 days was 0.61 (0.50, 0.73) and <14 days was 0.60 (0.49, 0.70).
ConclusionsCervical length ranging 15–30 mm combined with a positive PAMG-1 test result has a high accuracy to predict imminent spontaneous delivery within 7 days by women with preterm labor and cervical dilatation <3 cm in clinical practice.

Placental α-microglobulin-1 in cervicovaginal fluid and cervical length to predict preterm birth by Thai women with symptoms of labor

Department of Obstetrics and Gynaecology, Faculty of Medicine, Siriraj Hospital

Office for Research and Development, Faculty of Medicine Siriraj Hospital

Asian Biomedicine

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

BackgroundPresence of placental α microglobulin-1 (PAMG-1) in cervicovaginal fluid is a bedside test to predict preterm delivery.
ObjectiveTo determine whether...

Placental α-microglobulin-1 in cervicovaginal fluid and cervical length to predict preterm birth by Thai women with symptoms of labor

Article Category: Original article

Published Online: Jun 30, 2021

Page range: 119 - 127

DOI: https://doi.org/10.2478/abm-2021-0015

Keywords
cervical length measurement, IGFBP1 protein, human, PAMG-1 protein, human, premature birth, term birth

© 2021 Saifon Chawanpaiboon et al., published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Placental α-microglobulin-1 in cervicovaginal fluid and cervical length to predict preterm birth by Thai women with symptoms of labor

Article Category: Original article

Published Online: Jun 30, 2021

Page range: 119 - 127

DOI: https://doi.org/10.2478/abm-2021-0015

Keywordscervical length measurement, IGFBP1 protein, human, PAMG-1 protein, human, premature birth, term birth

© 2021 Saifon Chawanpaiboon et al., published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Keywords
cervical length measurement, IGFBP1 protein, human, PAMG-1 protein, human, premature birth, term birth