Beta hCG, urea and creatinine levels in vaginal fluids: a reliable marker for prelabour rupture of membranes

Abstract

Objective: To study the levels of β-hCG, urea and creatinine in vaginal fluid for diagnosis of prelabour rupture of membranes (PROM). Methodology: This was observational cross sectional comparative study divided into two groups. Group A (cases)- Pregnant women with gestational age 28-40 weeks presenting with history of leaking per vaginum without onset of labor pains, and who are clinically diagnosed as prelabor rupture of membranes. Group B (control) - Pregnant women with gestational age 28-40 weeks without PROM. T-test and chi-square test was used to calculate and to measure a quantitative and qualitative variables. Receiver operating characteristic curve was be used to determine a cut-off value. Cut-off point was set at highest optimal sensitivity and specificity. Results: Demographic data of both groups were comparable. Vaginal fluid value of β-hCG, urea and creatinine was significantly higher in study group. The sensitivity, specificity and cut-off value of vaginal fluid β-hCG 95%, 83.3% and >9 mg/dl respectively. The sensitivity, specificity and cut-off value of vaginal fluid urea/creatinine were 63.33/86.67%, 98.3/48.3% and >3.4/>0.08 IU/L respectively. The area under curves was 0.967 for β-hCG, 0.849 for urea, 0.742 for creatinine and 0.838 for AFI. Conclusions: Detection of vaginal fluid β-hCG, urea and creatinine to diagnose PROM is a simple, reliable and rapid test. So, introduction of these methods into routine use even in low resources community settings is feasible, practical and cost-effective.

Keywords

• prelabour rupture of membrane (prom)
• β-hcg
• urea
• creatinine
• vaginal