title: β-human chorionic gonadotropin assay in vaginal washing fluid for the accurate diagnosis of premature rupture of membranes during late pregnancy.
abstract: OBJECTIVE
  To determine whether the measurement of beta-human chorionic gonadotropin (β-hCG) levels in vaginal fluid is useful for the diagnosis of premature rupture of membranes (PROM).
  
  
  METHODS
  A total of 92 pregnant women between 24 and 40 weeks gestation participated in this study. The patients with fluid leaking from the vagina were designated Group 1, the patients with no fluid leaking from the vagina were Group 2, and those with a suspicion of fluid leaking from the vagina were classified as Group 3. Irrigating the posterior vaginal fornix with 5 mL sterile saline was used to measure β-hCG levels of the patients. Receiver operator curve (ROC) analysis was used to determine the cut-off value for a positive diagnosis.
  
  
  RESULTS
  The β-hCG levels of vaginal fluid were measured as 20.5±25.0 mIU/mL, 254.6±346.8 mIU/mL, and 74.3±100.8 mIU/mL in Group 1, Group 2, and Group 3, respectively. Vaginal β-hCG level was higher statistically significantly in Group 2 than Group 1 and 3 (p<0.001). 100 mIU/mL was accepted as a cut-off value by using the receiver operating characteristic curve. According to 100 mIU/mL, sensitivity, specificity, positive predictive and negative predictive values were calculated as 71.2, 100, 100, and 65.1%, respectively.
  
  
  CONCLUSIONS
  The study showed that the measurement of β-hCG level in vaginal washing fluid is an efficient and easy diagnostic test for predicting the amount of fluid leaking from the vagina. However, due to the low negative predictive value of the test, it would not be convenient in daily practice.
authors.affiliation: Department of Obstetrics and Gynecology, Zeynep Kamil Training and Research Hospital, İstanbul, Turkey.
authors.forename: Orhan
authors.initials: O
authors.lastname: Temel
authors.affiliation: Department of Obstetrics and Gynecology, Zeynep Kamil Training and Research Hospital, İstanbul, Turkey.
authors.forename: Ebru
authors.initials: E
authors.lastname: Cöğendez
authors.affiliation: Department of Obstetrics and Gynecology, Zeynep Kamil Training and Research Hospital, İstanbul, Turkey.
authors.forename: Selçuk
authors.initials: S
authors.lastname: Selçuk
authors.affiliation: The University of Texas MD Anderson Cancer Center, Houston, Texas, United States of America.
authors.forename: Mehmet Reşit
authors.initials: MR
authors.lastname: Asoğlu
authors.affiliation: Department of Obstetrics and Gynecology, Zeynep Kamil Training and Research Hospital, İstanbul, Turkey.
authors.forename: Erdal
authors.initials: E
authors.lastname: Kaya
keywords: Beta-human chorionic gonadotropin; diagnosis; premature rupture of membranes