COMBINED APPLICATION OF PLACENTAL ALPHA MICROGLOBULIN-1 (PAMG-1) AND INSULIN-LIKE GROWTH FACTOR IN THE DIAGNOSIS OF PRETERM BIRTH - OUR RESULTS
Keywords:
premature birth, high risk, insulin-like growth factorAbstract
Placental alpha microglobulin-1 (PAMG-1) is a human protein that was first isolated in 1975 from amniotic fluid. PAMG-1 is an important biomarker for detecting premature rupture of the amniotic membrane, as the high concentration of PAMG-1 in amniotic fluid means that there is a high risk of initiating labor.
The insulin-like growth factor IGFBP-1 is a binding protein (IBP-1), also known as placental protein (PP12), is encoded in people as IGFBP-1 gene. It is a particularly important hormone in female reproductive physiology. Its presence in large quantities in amniotic fluid is used as a biochemical marker of preterm birth. The aim of the present study was to conduct retention therapy to reduce the risk of preterm birth by detecting the presence of the specific indicator plGFBP-1 in cervicovaginal secretions in the period 24 - 34 gestational weeks using two biochemical tests and to determine their prognostic value. Material and methods. A prospective study was performed in the maternity ward of MHAT "St. Anna" - Varna AD in the period August 2021 - December 2021, including 120 pregnant women from Varna and the region. The gestation period of the examined patients is 24-34 gestational weeks. Respondents were divided into two main groups: group 1 - 60 pregnant women with clinical symptoms of preterm birth and group 2 - 60 women without clinical symptoms of preterm birth, with a history of preterm birth and increased risk. Both groups underwent two biochemical tests (Actim Partus and Parto Sure). All with positive tests were given retention therapy with Aleract, Gynipral and Utrogestan on a 30-day schedule. The results of a study to determine pIGFBP-1 in 120 pregnant women show that 35.8% (43 women) tested positive, with 12.5% (15 women) giving birth before 37 weeks of gestation, despite applied tocolytic therapy. In both tests, the mean gestational age of the premature fetus was 32.5 ± 2.8 gestational weeks.
References
ACOG news release October 31, 2003: Progesterone recommended in certain high risk pregnancies to help prevent preterm birth.
Altinkaya, O. et al. (2008). Cervical phosphorilated insulin-like growth factor binding protein-1 in prediction of preterm delivery. - Arch. Gynecol. Obstet.
American College of Obstetricians and Gynecologists (ACOG). Assessment of Risk Factors for Preterm Birth. - ACOG Practice Bulletin, No31, October 2001 (reaffirmed 2008).
Andersen, H.F. (2000). Use of fetal fibronectin in women at risk for preterm delivery. - Clin. Obset. Gynecol., 43, 746-758.
Ascarelli, M.H., & Morrison, J.C. (1997). Use of fetal fibronectin in clinical practice. - Obstet Gynecol. Surv., 52, 1-12.
Bashore, R.A., & Westlake, J.R. (1997). Plasma levels of unconjugated estriol in high-risk pregnancy. - Am. J. Obstet. Gynecol., 128, 371-80.
Berghella, V., et al. (2009). Fetal Fibronectin Testing for Reducing the Risk of Preterm Birth. - The Cochrane Library, 2.
Brinkman, A., Groffen, C., Kortleve, D.J., Geurts van Kessel, A., & Drop, S.L. (1988). Isolation and characterization of a cDNA encoding the low molecular weight insulin-like growth factor binding protein-1.- EMBO J., 7(8), 2417-23.
Delia, Maria Paternoster et al. (2007). Cervical pIGFBP-1 in the evaluation of the risk of preterm delivery.- Acta. Obstet Gynecol., 86, 151-155.
Goldenberg, R.L., Culhane, J.F., Lams, J.D. et al. (2008). Epidemiology and causes of preterm birth. - Lancet, 5, 371(9606), 75-84.
Honest, H. et al. (2002). Accuracy of cervicovaginal fetal fibronectin test in predicting risk of spontaneous preterm birth. - BMJ, N2325, 301-320.
Kekki, M., T. Kurki, T. Kärkkäinen, J. Paavonen, E-M Rutanen (2001). Insulin-like growth factorbinding protein-1 in cervical secretions as a predictor of preterm delivery. - Acta Obstet. Gynecol. Scand., 80, 546-551.
Kekki, M., Kurki, T., Paavonen, J., & Rutanen, E-M. (1999). Insulin-like growth factor-binding protein-1 in cervix as a marker of infectious complications in pregnant women with bacterial vaginosis. - Lancet, 353, 1494.
Kolev, N., & Kovachev, E. (2013). Modern diagnostic methods of preterm birth. // Obstetrics and Gynecology, 52, application 2, part 1, 5-10.ISSN: 0324-0959
Kolev, N., & Ivanov, S. (2015). Combined use of fetal fibronectin and insulin-like growth factor in the diagnosis of preterm birth - our results. // Obstetrics and Gynecology, 54, No 3, 8-12.ISSN: 0324-0959
Kolev, N., & Atanasova, T. (2021). Tocolysis with Alleract: Application in modern obstetric practice. International journal, Vol. 48.3., pp 369 – 602. ISSN 2545-4439; ISSN 1857-923X
Konoplyannikov, A., Lysyuk, I., Sokolyan, A., Pipia, N., Apresyan, S., & Karasova, A. (2016). PAMG-1 biomarker test (PARTOSURE) in combination with transvaginal ultrasound for improved assessment of spontaneous preterm birth in patients with threatened preterm labor. The Journal of Maternal-Fetal and Neonatal Medicine, Vol 29, 2016 – Issue sup 1
Lembet, A. et al. (2002). New rapid bed-side test to predict preterm delivery: phosphorilated insulin-like growth factor binding protein-1 in cervical secretions. - Acta Obstet Gynecol. Scand., 81, 706-712.
Lou, Y.Y., & Ajay, B. I. (2016). PartoSure effective in assessing preterm birth. BJOG. An international Journal of Obstetrics and Gynaecology; EPIa.021
Malinova, M. (2013). Clinical management in short cervix. - Obstetrics and Gynecology, 1, 41-48.
Meis, P. et al. (2003). Prevention of recurrent preterm delivery by 17 alpha-hydroxyprogesterone caproat. - NEJM, No348, 2379-85.
Nuutila, M. et al. (1999). Phosphorilated isoforms of insulin-like growth factor binding protein-1 in the cervix as a predictor ripenes. - Obstet. Gynecol., 94, 243-249.
Rutanen, E-M. (2000). Insulin-like growth factors in obstetrics. - Curr. Opin. Obstet Gynecol., 12, 163-168.
Yast, J.D., & Lu, G. (2007). Biochemical markers for the prediction of preterm delivery. - Clin. Perinatol., 34(4), 573-586.
