Vaginal fluid urea and creatinine in diagnosis of premature rupture of membranes.
OBJECTIVE
To evaluate the reliability of vaginal fluid urea and creatinine for the diagnosis of premature rupture of membranes (PROMs).


METHODS
A total of 139 pregnant women were recruited. Group I consisted of 47 patients with diagnosis of PROM confirmed by amniotic fluid pooling and nitrazine paper test. Group II consisted of 36 patients in whom diagnosis of PROM was suspected but unconfirmed by amniotic fluid pooling (+/-) and/or nitrazine paper test (+/-). Group III consisted of 56 pregnant women without any complaint or complication. All patients underwent speculum examination for amniotic fluid pooling, nitrazine paper test, vaginal washing fluid urea and creatinine sampling. One-way ANOVA test, Scheffe multiple comparison test and receiver operating characteristic curve analysis were used.


RESULTS
The mean vaginal fluid urea levels in group I, II, and III were 34.6 +/- 5.3, 2.4 +/- 5.3 and 1.3 +/- 6.2 mg/dl, respectively, where the difference was statistically significant (P < 0.001). The mean vaginal fluid creatinine concentrations of group I were, 1.5 +/- 0.3 mg/dl, found higher against the group II, 0.34 +/- 0.22 mg/dl, and group III, 0.28 +/- 0.23 mg/dl (P < 0.01). The sensitivity, specificity, positive predictivity, and negative predictivity were all 100% in detecting PROM by evaluation of vaginal fluid urea and creatinine concentration with a cut-off value of 12 and 0.6 mg/dl, respectively.


CONCLUSIONS
Vaginal washing fluid urea and creatinine determination for the diagnosis of PROM is a reliable, simple and rapid test.
Kafali
Hasan
H
Departments of Obstetrics and Gynecology, Harran University Medical School, Sanliurfa, Turkey. hasankafali@hotmail.com
Oksüzler
Cevdet
C
D000328:Adult; D000653:Amniotic Fluid / Q000737:chemistry*; D015415:Biomarkers / Q000032:analysis; D003404:Creatinine / Q000032:analysis*; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000175:diagnosis*; D006801:Humans; D011237:Predictive Value of Tests; D011247:Pregnancy; D015203:Reproducibility of Results; D014508:Urea / Q000032:analysis*; D014621:Vagina
D015415:Biomarkers; D014508:Urea; D003404:Creatinine