role of vaginal prolactin in diagnosis of premature rupture of membranes

Premature rupture of membranes [PROM] is one of the most common complications of pregnancy that has a major impact on pregnancy outcomes. A diagnostic tool that is non-invasive, specific and quick is needed to predict PROM. The purpose of this study was to evaluate the diagnostic power of the vaginal washing fluid prolactin for the diagnosis of premature rupture of membranes and to determine cut-off values. A total of 114 pregnant women were recruited in this diagnostic trial. The PROM group consisted of 54 pregnant women between 20 and 41 weeks of gestation with diagnosis of confirmed PROM [amniotic fluid pooling [+] and Nitrazine paper test [+] and fernt test [+]]. The control group consisted of 60 pregnant women between 20 and 41 weeks of gestation without any complaint or complication. All patients underwent speculum examination for amniotic fluid pooling, nitrazine paper test, fern test, vaginal washing fluid prolactin sampling. Vaginal fluid concentrations of prolactin was significantly different between the two groups [P<0.001]. The sensitivity, specificity, positive and negative predictive values and accuracy were 87.03%, 75.0%, 75.80%, 86.53% and 83.33% in detecting PROM by evaluation of vaginal fluid prolactin concentration with a cut-off value of 9.50 micro IU/ml, respectively. The prolactin levels in the washing fluid of the posterior vaginal fornix in our experience is reliable and non-invasive diagnostic tests of PROM

Comparison of ELISA and three rapid HCG dipsticks in diagnosis of premature rupture of membranes

The importance of accurate diagnosis of premature rupture of membranes [PROM] is quite apparent while trying to diminish false negative or positive results as much as possible. This study compares Enzyme-Linked Immunosrbent Assay [ELISA] and three rapid human chorionic gonadothropin [HCG] dipsticks in diagnosis of premature rupture of membranes. During 2008-2009, 181 pregnant women with single pregnancy from 14 to 41 weeks of gestation who referred to Ayatollah Taleghani Hospital in Tehran, Iran were divided into two groups, 91 patients with PROM and 90 controls with matched gestational weeks. All patients underwent speculum examination for cervicovaginal washing fluid, HCG three rapid tests and ELISA. The HCG concentration of vaginal fluid was significantly different between the two groups. Using receiver operating characteristic [ROC] curve and determining the threshold as 19 mlU/mL for HCG by ELISA method, the sensitivity was 94.5%; specificity, 91%; positive predictive value, 91.5%; negative predicted value, 94.2% and accuracy was 92.2%. In rapid diagnostic test, the most sensitivity was for ACON and the most specificity for DIMA. Comparing the four methods, DIMA strip showed the highest accuracy and the highest value in early diagnosis of ROM. The reliability of three rapid diagnostic tests in diagnosis of ROM in cervicovaginal discharge was acceptable