ABSTRACT
Several markers have been
studied to diagnose PROM but there is still limitation with a gold standard
test for the diagnosis [1]. Objective: To evaluate and compare the accuracy of urea,
creatinine and hCG in vaginal fluid washing for diagnosis of PROM and to
determine cut off levels. Type of the study: Prospective study performed on
pregnant women in their third trimester who are coming to Kasr El Ainy
maternity outpatient clinic with history of fluid leakage. Patients and
methods: 150 patients between 26 - 40 weeks were included in the study. Group I
included 50 patients with clinically confirmed ROM, group II included 50 with
unconfirmed ROM and 50 controls with no complaints (group III). All patients
were subjected to speculum examination for amniotic fluid pooling, nitrazine
paper test, vaginal fluid washing for measurement of creatinine, urea and β-hCG, and ultrasound examination. The
results were compared as regards the 3 study groups. Results: There was no
statistically significant difference among the 3 study groups as regards age,
parity BMI, nor gestational age. There was a statistically significant
difference in creatinine level among confirmed, suspected and control groups. Urea
levels showed also a statistically significant difference among the three
groups. There was a positive correlation between vaginal creatinine and urea
and gestational age in the 3 groups (r = 0.43, and 0.51 respectively). There
was a statistically significant difference between vaginal fluid wash urea and
creatinine levels and β-hCG as sensitivity, specificity,
positive and negative predictive values and accuracy for urea and creatinine
were all 100% and for qualitative β-hCG 83%, 100%, 100%, 85.6%, and 91%
respectively. Conclusion: Urea and creatinine in vaginal washings can be
accurately used in diagnosing suspected PROM and are more accurate than β-HCG.