الفهرس | Only 14 pages are availabe for public view |
Abstract Background: preterm PPROM complicates 2% to 20% of all deliveries. The accurate diagnosis of preterm is important, because it is associated with infectious morbidity of mother and fetus, cord prolapse and preterm labor. Aim of the Work: this study aimed to determine whether the measurement of beta-human chorionic gonadotropin (β-hCG) levels in vaginal fluid is accurate for the diagnosis of premature rupture of membranes (PPROM). Patients and Methods: this prospective case control study was conducted in Ain Shams Maternity Hospital. On 60 healthy pregnant women with gestational age between 24-36 weeks, single intrauterine pregnancy. Results: vaginal β-hCG had excellent diagnostic value as denoted by an area under the ROC curve of 1.0 with 95% confidence limits ranging from 0.94 to 1.0 (p-value <.0001). The best cut-off value was a vaginal β-hCG concentration of >56 mIU/ml which had a sensitivity of 100% with 95% confidence limits ranging from 86.2% to 100% and a specificity of 100% with 95% confidence limits ranging from 86.2% to 100%. Conclusion: the diagnosis of rupture of membrane can be very difficult when there is only minimal amniotic fluid leakage. In this study, a high sensitivity, specificity, PPV and NPV for the β-hCG qualitative test in cervicovaginal washing in patients with confirmed rupture of membranes, but subtle and invisible amount of amniotic fluid in the vagina. Recommendations: these findings showed that this simple, rapid, and inexpensive test may be useful in detecting PPROM in equivocal cases. |