Diagnostic Accuracy of IGFBP-1 (ACTIM-PROM) Versus the Nitrazine Test for Preterm Premature Rupture of Membranes

Pande Putu Firsta Widyaning (Faculty of Medicine Universitas Brawijaya, Dr. Saiful Anwar Malang General Hospital, Malang)
Mukhammad Nooryanto (Faculty of Medicine Universitas Brawijaya, Dr. Saiful Anwar Malang General Hospital, Malang)
Rahajeng Rahajeng (Faculty of Medicine, University of Brawijaya East Java, Indonesia)
Cholid Rochman Riskianto (Faculty of Medicine Universitas Brawijaya, Dr. Saiful Anwar Malang General Hospital Malang)

Indonesian Journal of Obstetrics and Gynecology (Majalah Obstetri dan Ginekologi Indonesia)
Volume 14. No. 3 July 2026

Objective: To evaluate the diagnostic performance of insulin-like growth factor-binding protein-1 (IGFBP-1; ACTIM PROM) compared with the nitrazine test for the diagnosis of preterm premature rupture of membranes (PPROM). Methods: This observational analytical study included 30 pregnant women, comprising 15 women with PPROM and 15 controls. Posterior fornix fluid collected during a sterile speculum examination was analyzed using both the nitrazine test and the ACTIM PROM immunoassay. Results: The nitrazine test demonstrated a sensitivity of 80.0%, specificity of 73.3%, and overall diagnostic accuracy of 76.6%. ACTIM PROM demonstrated a sensitivity of 93.3%, specificity of 100%, and overall diagnostic accuracy of 96.6%. ACTIM PROM showed significantly higher specificity than the nitrazine test, whereas no significant difference was observed in sensitivity. Conclusion: ACTIM PROM demonstrated superior specificity and overall diagnostic accuracy compared with the nitrazine test and may serve as a reliable diagnostic tool for the diagnosis of PPROM. Keywords: ACTIM PROM; diagnostic accuracy; IGFBP-1; nitrazine test; preterm premature rupture of membranes.