The Evaluation Of Diagnostic Role Of Vaginal Fluid Urea, Creatinine And Β-HCGLevel For Detection Of Premature Rupture Of Membrane.

Abstract

Purpose: Diagnosis of premature rupture of membrane (PROM) is difficult in equivocal cases. The concentration of β-HCG, urea and creatinine are high in amniotic fluid. The purpose of this study is to compare the value of vaginal fluid β-HCG, Urea and creatinine level for better diagnosis of PROM. Methods: This study was performed between November 2007 and November 2008, in the Zeinabieh hospital of Shiraz university medical sciences, Iran. A total of 153 pregnant women were recruited in 3 groups. Group I: patients with diagnosis of PROM confirmed by amniotic fluid pooling and ferning test, Group II: patients in whom diagnosis of PROM was suspected but unconfirmed by amniotic fluid pooling or ferning test and Group III: pregnant women without any complaint. All the patients underwent speculum examination for amniotic fluid pooling, ferning test and vaginal washing fluid for β-HCG, urea and creatinin sampling. Results: All the three markers were significantly highest in the experimental group. The sensitivity, specificity, positive predictive value and negative predictive value for β-HCG were 84.3%, 94.1%, 92% and 90% respectively. creatinine values were 90.2%, 91.2%, 83.6% and 90% respectively and the values for Urea they were 100%, 76.5%, 70.6% and 96% respectively. Conclusion: The urea has the most sensitivity among the three markers but βHCG and Creatinin are more specific for diagnosis of PROM.