الفهرس 
Premature Rupture of MembranesOnly 14 pages are availabe for public view
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Abstract
Prelabour rupture of membranes (PROM) complicates about10% of all pregnancies, and at least 60% of cases occur at term.Despite the recent advances in perinatal care, ROM before labour continues to lead to important morbidity in the mother and the infant. Some of these complications are associated with the PROM itself (infection, prematurity, cord prolapse) and others are associated with the clinical management (failed labour induction, prolonged labour, induced prematurity). Thus, a correct diagnosis of the state of fetal membranes is crucial. Diagnosis of ROM is easy when the rupture is obvious, but it can be extremely difficult. Various tests have been used. Crystallisation test, with ferning pattern, and nitrazine test, a dye test for alkaline pH, have been criticised for their high number of false positive and false-negative results. Ultrasonographic measurement of the amount of amniotic fluid is not likely to detect minor leakage, and the presence of oligohydramnios is not always caused by a ROM. Therefore, a rapid, reliable and non invasive test would be of value to the clinician to diagnose ROM. Insulin-like growth factor binding protein-1 (IGFBP-1)has been promoted as a reliable marker in this context of ROM. IGFBP-1 is a major protein produced by human decidua, and its concentration in the amniotic fluid is 100 to 1000 times higher than in the serum.(202) The phosphorylation status of IGFBP-1 in the decidua differs from that in the amniotic fluid.(203) Amniotic fluid contains nonphosphorylated and lesser phosphorylated isoforms whereas the decidua contains highly phosphorylated isoforms.