TITLE:
The Study of Vaginal Fluid Urea, Creatinine, B-HCG and Placental Alpha-1 Microglobulin in Diagnosis of Premature Rupture of Membranes
AUTHORS:
Khaled E. Said, Amin A. Tantawy, Hesham M. Borg, Ghada A. Suliman
KEYWORDS:
β-HCG, PAMG-1, Premature Rupture of Membranes (PROM)
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.9 No.6,
June
11,
2019
ABSTRACT: Purpose: To evaluate and compare the reliability, accuracy
and the cost benefit ratio of vaginal
washing fluid urea, creatinine, Beta Human Chorionic Gonadotropin (β-HCG) and placental alpha
Microglobulin-1 (PAMG-1) for diagnosis of premature rupture of membranes
(PROM). Material and Methods: A diagnostic study conducted on 70 patients. The patients were divided
into three groups: Group A (n = 25): (Confirmed PROM group) patients who were either in labor or not in
labor, Gestational age was from 24 weeks onwards and fulfilled the following criteria and/or two of
these criteria with low AFI positive pooling, positive nitrazine paper test, positive fern test. Group B (n = 25):
(Suspected PROM group) patients who fulfilled the following criteria: Patients
with fluid leakage complaint with negative pooling and/or negative nitrazine paper test and/or negative fern test.
Group C (n = 25): (Control group with
no PROM) patients that were admitted to prenatal clinic for their regular
prenatal control visit with 24 - 42 weeks of gestational
age without any complaint or complication and with negative pooling, negative nitrazine paper test and/or negative fern test.
The vaginal washing fluid urea, creatinine, Beta-Human Chorionic Gonadotropin (β-HCG) and placental alpha
Microglobulin-1 (PAMG-1) were determined for diagnosis of premature rupture of membranes (PROM). Results: PAMG-1 detection in cervico vaginal discharge was a very good test for diagnosis of PROM with high sensitivity,
specificity, positive predictive value, negative predictive value, accuracy and
P-value (96%, 100%, 100%, 95.84%, 97.78% and diagnosis of PROM with high sensitivity, and specificity after PAMG-1 with a privilege of
low cost than PAMG-1. Furthermore they
were more accurate than β-HCG. Conclusion: Detection of PAMG-1 in cervico vaginal discharge is promising in diagnosis of
PROM & especially in those cases of suspected PROM and it should be done as a worse trial in every case of suspected PROM. Urea and
Creatinine is the second option in diagnosis of PROM with high sensitivity, and specificity after PAMG-1 with a privilege of
low cost than PAMG-1. Also they were more
accurate than β-HCG and they can be
used if PAMG-1 is not available for detection of doubtful PROM cases.