Vaginal fluid beta-human chorionic gonadotropin level in the diagnosis of premature rupture of membranes.
BACKGROUND
To determine whether the measurement of beta-human chorionic gonadotropin (beta-HCG) level in the vaginal washing fluid could be useful for the diagnosis of premature rupture of membranes.


METHODS
Totally, 120 pregnant women were enrolled in this study. Subjects were divided into four groups [group I, no preterm labor and term delivery (n = 38); group II, preterm labor and term delivery (n = 12); group III, preterm labor and consequent premature delivery (n = 24); group IV, preterm labor with premature rupture of membranes (PROM) and consequent premature delivery (n = 46)]. After irrigating the posterior vaginal fornix with 3 ml of sterile saline and the obtained vaginal washing fluid, we measured beta-HCG levels.


RESULTS
The median and range of vaginal fluid beta-HCG levels were 3.60 (0.09-30.52), 4.42 (0.33-10.02), 15.50 (0.25-378.62), and 512.53 (26.95-3507.20) mIU/ml in group I, group II, group III, and group IV, respectively. Vaginal beta-HCG level was significantly higher in patients with PROM followed by premature delivery (group IV) than patients in other groups (P < 0.01). From the receiver operating characteristic curve, 39.8 mIU/ml was set as a cutoff value. Sensitivity, specificity, positive predictive value, and negative predictive value were 95.5, 94.7, 91.3, and 97.3%, respectively.


CONCLUSIONS
Our study demonstrated that the measurement of vaginal fluid beta-HCG may be reliable, simple, and rapid test in diagnosing PROM and used as a adjunctive test in equivocal cases.
Kim
Young-Han
YH
Department of Obstetrics and Gynecology, College of Medicine, Yonsei University, 134 Shinchoin-Dong, Sedaemun-Ku, Seoul 120-752, Korea. yhkim522@yumc.yonsei.ac.kr
Park
Yong-Won
YW
Kwon
Han-Sung
HS
Kwon
Ja-Young
JY
Kim
Bok-Ja
BJ
D000328:Adult; D015415:Biomarkers / Q000032:analysis; D001826:Body Fluids; D018997:Chorionic Gonadotropin, beta Subunit, Human / Q000032:analysis / Q000378:metabolism*; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000175:diagnosis*; D005500:Follow-Up Studies; D006801:Humans; D008423:Maternal Age; D010298:Parity; D011237:Predictive Value of Tests; D011247:Pregnancy; D011256:Pregnancy Outcome; D011262:Pregnancy Trimester, Second; D011263:Pregnancy Trimester, Third; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D014621:Vagina / Q000737:chemistry*
D015415:Biomarkers; D018997:Chorionic Gonadotropin, beta Subunit, Human