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Placental alpha microglobulin-1 (PAMG-1): Wikis

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Placental alpha microglobulin-1 (PAMG-1) was isolated in 1975 from amniotic fluid by D. Petruin and was originally referred to as specific alpha-1 globulin of placenta.[1]

PAMG-1 is present in blood and the amniotic fluid and cervico-vaginal discharge of pregnant women. The concentration of PAMG-1 in the amniotic fluid of pregnant women (2,000–25,000 ng/ml), however, is several thousand magnitudes higher than that found in their background cervico-vaginal discharge when the fetal membranes are intact (0.05–0.2 ng/ml). It has been found to be present in amniotic fluid in significantly high concentrations throughout all three trimesters of pregnancy.

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Diagnostic potential

Because of its contrasting concentrations in the amniotic fluid and background cervico-vaginal discharge of pregnant women, PAMG-1 proves to be an excellent protein marker for amniotic fluid. Detecting amniotic fluid via PAMG-1 becomes particularly important when determining whether or not fetal membranes are ruptured. Premature rupture of fetal membranes (or PROM as it is more commonly referred) occurs in roughly 10% of pregnancies [2] and is one of the most common diagnoses associated with premature delivery and neonatal complications that requires admission to the NICU. [3] Risks of neonatal complications as a result of PROM can include infection, [4] preterm delivery, [5] fetal distress, prolapsed cord , and abruptio placenta. [6]

Diagnostic applications

Today, the diagnostic capability of the PAMG-1 protein is used by an immunoassay that employs a series of monoclonal antibodies (MABs) to the PAMG-1 protein. This immunoassay detects the presence of PAMG-1 in the cervico-vaginal discharge of pregnant woman and has been shown to detect rupture of membranes with approximately 99% accuracy. [3]

Additional resources

Contemporary Diagnosis and Management of Preterm Premature Rupture of Membranes

/ Comparison of Two Rapid Strip Tests Based on IGFBP-1 and PAMG-1 for the Detection of Amniotic Fluid

References

  1. ^ D. Petrunin, et al., "Immunological Identification of Organ Specific alpha-1 Globulin of Human Placenta and Its Content in the Amniotic Fluid," in Akusherstvo i Ginekologiya, 1977, N 1, pp. 64-65, Moscow, USSR)
  2. ^ Alexander JM, Cox SM. Clinical course of premature rupture of the membranes. Semin Perinatol 1996;20:369–374
  3. ^ a b Cousins L, Smok D, Lovett S, Poeltler D. AmniSure® Placental Alpha Microglobulin-1Rapid Immunoassay vs Standard Diagnostic Methods for Detection of Rupture of Membranes. Am Jour of Peri. 2005; Vol 22
  4. ^ Philipson EH, Hoffman DS, Hansen GO, Ingardia CJ. Preterm premature rupture of membranes: experience with latent periods in excess of seven days. Am J Perinatol 1994; 11:416–419
  5. ^ Mercer BM, Goldenberg RL, Meis PJ, et al. The Preterm Prediction Study: prediction of preterm premature rupture of membranes through clinical findings and ancillary testing. The National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network. Am J Obstet Gynecol 2000;183:738–745
  6. ^ French JI, McGregor JA. The pathobiology of premature rupture of membranes. Semin Perinatol 1996;20:344–368
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