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Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet]. York (UK): Centre for Reviews and Dissemination (UK); 1995-.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet].

Methods for the diagnosis of rupture of the fetal membranes in equivocal cases: a systematic review

Review published: 2011.

Bibliographic details: van der Ham DP, van Melick MJ, Smits L, Nijhuis JG, Weiner CP, van Beek JJ, Mol BW, Willekes C.  Methods for the diagnosis of rupture of the fetal membranes in equivocal cases: a systematic review. European Journal of Obstetrics and Gynecology and Reproductive Biology 2011; 157(2): 123-127. [PubMed: 21482018]

Abstract

Prelabor rupture of membranes (PROM) is a common obstetrical problem, but its diagnosis is frequently problematic. Lacking a gold standard, the diagnosis is equivocal in some 10% of cases. We performed a systematic review to assess the accuracy of several tests for the diagnosis of PROM in these equivocal cases. We performed an electronic search in PubMed, Embase, DARE and the Cochrane Library and reference lists for potentially missed articles. No language restrictions were used. Only accuracy studies for diagnostic methods for PROM in women with equivocal PROM were selected. The studies were scored according to STARD and QUADAS guidelines. Based on the full description of reference and index tests, an expert panel finally decided whether the selected articles were of sufficient quality to be included. We identified 3864 studies of which 146 full manuscripts were obtained. We excluded 133 due to multiple reasons. The remaining 13 studies were scored by an expert panel. Only three articles with a total of 155 patients fulfilled all criteria. These articles tested three different methods, pH measurement (64 patients), insulin-like growth factor binding protein-1 (ILGBP-1, 83 patients) and alpha fetoprotein (AFP, 8 patients). Sensitivity varied from 88% (pH) to 100% (AFP), specificity varied from 56% (ILGPP-1) to 100% (AFP). Based on the limited evidence on the accuracy of tests to diagnose ruptured membranes, we conclude that the use of a particular test cannot be recommended.

Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

CRD has determined that this article meets the DARE scientific quality criteria for a systematic review.

Copyright © 2014 University of York.

PMID: 21482018

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