Vol. 78, December 2010

Cervico-Vaginal Fluid ß-Subunit Human Chorionic Gonadotrophin for Diagnosis of Preterm Premature Rupture of Membranes

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Cervico-Vaginal Fluid ß-Subunit Human Chorionic Gonadotrophin for Diagnosis of Preterm Premature Rupture of Membranes,MOHAMED ABD EL-RAZIK, ABD EL-FATAH HEGAZY, MOHAREM ABD EL-HASEEB and MOHAMED TAWFEEK

 

Abstract
Objective: To determine the diagnostic value of qualitative testing of ß- subunit human chorionic gonadotrophin (ß-HCG) in the cervico-vaginal fluid for the diagnosis of preterm premature rupture of membranes (PPROM).
Design: A prospective, cross section, controlled study.
Setting: Departments of Obstetrics and Gynecology, Benha University Hospital and Benha Insurance Hospital, during the period from January 2009 to December 2009.
Subjects and Methods: The study was performed on two groups of pregnant women between 28-34 weeks of gestation each 50 cases. The PPRM group was pregnant with recent history of watery vaginal discharge and confirmed diagnosis of rupture of membranes evident by visualization of amniotic fluid leaking from the cervix. The control group was normal pregnant, having no complaints and attending for routine ante natal care. Three drops of the liquor from the PPRM group, or the saline washed vaginal discharge from the normal control group were aspirated and applied on the one step cassette style ß-HCG urine pregnancy test (IND Diagnostic Inc-Canada). This test is sensitive at HCG level of 20mIU/ml which is higher than the mean level in the cervico-vaginal discharge of normal pregnancy; so a positive test indicated amniotic fluid and a negative test exclude amniotic fluid.
Results: The test was 90% sensitive and 98% specific in the detection of amniotic fluid and diagnosis of PPRM. The positive predictive value was 97.8%, the negative predictive value was 90.7%, and the overall accuracy of the test was 94%.
Conclusions: The qualitative ß-HCG urine pregnancy test with a sensitivity of 20mIU/ml is simple and cheap test that can be used as an outpatient or a bedside test for rapid diagnosis of PPROM in the third trimester.

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