Introduction Preterm labour is one of the commonly encountered problems in pregnancy complicating nearly 20% of women. It is not only a cause for increased perinatal morbidity and mortality, but also a burden on resources. The diagnosis can be challenging and is complicated by various factors. PhIGFBP-1 in endocervical secretions is a useful marker for predicting the risk of preterm delivery. This audit was aimed to evaluate the practice and utilisation of PhIGFBP-1 testing in women presenting with symptoms suggestive of preterm labour.
Methods All women presenting with contractions and/or abdominal pain were tested for PhIGFBP-1 in endocervical secretions. Women showing contraction on CTG were also included. Women with PV bleeding, PROM and active labour (>4 cm cervical dilatation) were excluded.
Results 34 women satisfying the inclusion criteria were included. The median age of the women included in the study was 26. Women between 24 to 36 weeks gestation were included. The average gestational age was 31 (Median – 32, gestation age rounded off to the nearest week). All women included in the study presented with either history of abdominal pain and/or contractions. 2 women had a positive test, requiring admission, steroid administration but without tocolysis. They delivered at term. Two out of the 32 women who had a negative test delivered within a week of testing. The sensitivity of the test is very low with a specificity of 94%.
Conclusion PhIGFBP-1 is a very useful test in the management of women with threatened preterm labour. Negative test helps us to not only reassure women but also negates the need for admission, in-utero transfer, administration of steroids and hence helps reduce the financial burden on the Health care system in these times of austerity.
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