J L Bartha1, R Comino-Delgado, F Arce. 1. Department of Obstetrics and Gynecology, Hospital Universitario of Puerto Real, Cadiz, Spain.
Abstract
OBJECTIVE: To evaluate maternal serum alpha-fetoprotein levels in women with preterm labor. METHOD: Maternal serum alpha-fetoprotein level was measured in 58 women in preterm labor with intact membranes. Maternal levels and multiples of the median were compared in groups with preterm labors of different etiologies and between those with and without placental abruption. Women with vaginal bleeding were also studied separately. Sensitivity, specificity and predictive values were calculated for 2 multiples of the median. Chi squared, Fisher exact test, Mann Whitney U-test, Kruskal-Wallis test and logistic regression were all used. RESULTS: Those cases with placental abruption (n = 9) had a higher maternal serum alpha-fetoprotein level than the other groups (P = 0.033) and than that of all of them, in total, (n = 49) without placental abruption (P = 0.001). If only women with vaginal bleeding were taken into consideration (n = 13) the maternal serum alpha-fetoprotein level was higher in those with placental abruption (P = 0.001). If we had the criterion of 2 multiples of the median, sensitivity was 66.67%, specificity 95.92%, the positive predictive value 75%, and the negative predictive value 94%. In women with vaginal bleeding sensitivity was 100%, specificity 71.43%, the positive predictive value 75%, and the negative predictive value 100%. CONCLUSIONS: Maternal serum alpha-fetoprotein level is higher in women with preterm labor and placental abruption. This measurement could be used as a biochemical marker of placental abruption in cases of preterm labor.
OBJECTIVE: To evaluate maternal serum alpha-fetoprotein levels in women with preterm labor. METHOD: Maternal serum alpha-fetoprotein level was measured in 58 women in preterm labor with intact membranes. Maternal levels and multiples of the median were compared in groups with preterm labors of different etiologies and between those with and without placental abruption. Women with vaginal bleeding were also studied separately. Sensitivity, specificity and predictive values were calculated for 2 multiples of the median. Chi squared, Fisher exact test, Mann Whitney U-test, Kruskal-Wallis test and logistic regression were all used. RESULTS: Those cases with placental abruption (n = 9) had a higher maternal serum alpha-fetoprotein level than the other groups (P = 0.033) and than that of all of them, in total, (n = 49) without placental abruption (P = 0.001). If only women with vaginal bleeding were taken into consideration (n = 13) the maternal serum alpha-fetoprotein level was higher in those with placental abruption (P = 0.001). If we had the criterion of 2 multiples of the median, sensitivity was 66.67%, specificity 95.92%, the positive predictive value 75%, and the negative predictive value 94%. In women with vaginal bleeding sensitivity was 100%, specificity 71.43%, the positive predictive value 75%, and the negative predictive value 100%. CONCLUSIONS: Maternal serum alpha-fetoprotein level is higher in women with preterm labor and placental abruption. This measurement could be used as a biochemical marker of placental abruption in cases of preterm labor.