Diagnosis of premature rupture of fetal membranes by identification of vaginal fluid urea and creatinine

Background: Premature rupture of fetal membrane is one of the most common and controversial problem facing the obstetric clinician. Its Correct diagnosis has great importance because failure of diagnosis can lead to unwanted obstetric complications or over diagnosis can lead to unnecessary intervention

Objective: To evaluate the reliability of vaginal fluid urea and creatinine for the diagnosis of premature rupture of membrane

Patients and Methods: This study had been conducted in AL-Yarmouk Teaching Hospital, Department of Obstetrics and Gynecology. In this study, 105 pregnant women presented between 24-41 weeks of gestation were included, three groups were considered in this cohort, thirty five pregnant women with confirmed premature rupture of membrane [group A], thirty five pregnant women with suspected premature rupture of membranes[group B],and thirty five healthy pregnant women considered as control group [group C]. All patients underwent speculum examination for amniotic fluid pooling, nitrazine paper test, measurement of urea and creatinine in vaginal wash fluid sample, ultrasonographic examination for gestational age determination and amniotic fluid index calculation, and then the patients were followed up until delivery

Result: There was significant differences in the mean vaginal wash fluid urea and creatinine concentrations among the three groups [P < 0.001], being higher in group A than the other two groups. The gestational age at delivery and time interval between sampling and delivery was significantly shorter among patients in group A than group B and group C

Conclusion: Vaginal wash fluid urea and creatinine determination for the diagnosis of premature rupture of membrane in our study reported a comparable result in the sensitivity and specificity to other worldwide results

Vaginal washing fluid B-IICG levels for detecting premature rupture of membranes

Pre-labour rupture of the membrane is a common clinical problem, and the assessment of the woman with possible membrane rupture is management issue faced in every day practice. When premature rupture of membrane [PROM] occurs, the fetus loses the relative isolation and protection afforded within the amniotic cavity. To evaluate the reliability of vaginal washing fluid Beta-human chorionic gonadotropin for the detection of premature rupture of membrane and to determine a cut-off value. A prospective case-study includes 79 pregnant women subdividing into three groups [group A: 20 pregnant women with confirmed premature rupture of membranes, group B: 19 pregnant women with suspected premature rupture of membranes, group C: apparently healthy pregnant women without any complaint] for which speculum examination for amniotic pooling, nitrazine paper test, measurement of vaginal washing fluid Beta-human chorionic gonadotropin were performed. There was significant differences in mean vaginal washing fluid fl-HCG concentration among the three groups [p= 0.000], being higher in group A than the other two groups and the time interval between sampling and delivery was significantly shorter among patient in group A than group B and C. Vaginal fluid 3-HCG determination is reliable, simple and rapid test for the detection of PROM