Abstract

EVALUATION OF VAGINAL FLUID Β-HCG FOR THE DIAGNOSIS OF PREMATURE RUPTURE OF MEMBRANES

Tamer F. Oof, M.D*, Mohammed S. Fouad, M.D. and Islam N. Mohammed, M.B.B.Ch.

ABSTRACT

Objectives: The aim of this study is to determine the role of quantitative level of β-HCG in vaginal fluid in diagnosis of premature rupture of membranes. Design: Prospective case control randomized study. Setting: El-Hussein University and Sohag Teaching Hospitals from May 2016 – November 2016. Materials and Methods: A total of 150 pregnant women in gestational age between 20 and 40 weeks were included in this study and were divided into three groups: group I (conformed PROM), group II (suspected but unconfirmed PROM) and group III (intact membrane group). All patients underwent ultrasonographic examination for gestational age and amniotic fluid index (AFI) calculation, sterile speculum examination for detection of amniotic fluid pooling and Nitrazine paper testing followed by vaginal fluid sampling for measurement of quantitative level of β-HCG by immulite method. Results: The mean vaginal fluid hCG levels in group I, group II and group III were 455.80 ± 119.27, 113.24 ± 58.38 and 24.75 ± 15.15 mIU/mL respectively in which the difference was statistically significant (P<0.001). With hCG cut-off value ≥62 mIU/ml, the sensitivity100%, specificity98%, positive predictive value 100%, and negative predictive value 99% with diagnostic accuracy of 99.9% in confirming PROM. Conclusion: β-hCG titer was significantly higher in cases with definite PROM. Consequencely, vaginal fluid hCG can be used as an easy, rapid, reliable and noninvasive test for confirming the diagnosis of PROM and can be used as a adjunctive test in an equivocal cases.

Keywords: ?-human chorionic gonadotropin, premature rupture of membranes.