Urea and Creatinine Levels of Washed Vaginal Fluid a Gold Standard Test to Detect PROM
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- Category: Vol. 78, September 2010
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Urea and Creatinine Levels of Washed Vaginal Fluid a Gold Standard Test to Detect PROM, AMAL HANFY
Abstract
Objectives: To assess the reliability of the diagnosis of Pre-labor rupture of Membranes (PROM) by measuring the Urea and Creatinine levels in the vaginal amniotic fluid pool.
Patients and Methods: 150 pregnant patients in their third trimester were divided into three groups; Group (A): 50 patients with confirmed diagnosis of PROM, Group (B): 50 patients with suspected PROM, and group (C): 50 patients with intact membrane as control group. The vaginal pool washed by 5ml normal saline, then 3ml of them aspirated and sent to measure its urea and creatinine levels.
Results: The urea levels of 3.05mg/dl cut off value found to have sensitivity of 85%, specificity 100%, PPV 77% and NPV of 100%, with a diagnostic accuracy of 90%. However, the diagnostic accuracy of creatinine measurement was 74% with a sensitivity of 71%, specificity 80%, PPV 88% and NPV of 58% and this for a cut of value of 0.39mg/dl. The best cut off value of urea was 14.75mg/dl. This showed a 100% for sensitivity, specificity, PPV, NPV and diagnostic accuracy. The best cut off value for creatinine was 1.05mg/dl that showed sensitivity and PPV of 94%, specificity and NPV of 100% and the diagnostic accuracy was 97%.
Conclusion: Measurement of urea and creatinine levels in the washed vaginal pool is highly sensitive and specific diagnostic test for diagnosis of pre-labor rupture of membranes.