Vaginal Fluid Urea and Creatinine in the Diagnosis of Premature Rupture of Membranes

Abstract

Background Premature rupture of membranes occurs in 8% of pregnancies & the most frequent complication of it is preterm delivery with all its sequelae. It is very necessary to make a diagnosis of premature membrane rupture accurately in order to avoid the unnecessary interventions & to lessen the complication of the mother & the fetus. Aims; Is for estimation the reliability of vaginal fluid creatinine and urea among pregnant women to diagnose premature rupture of membranes. Subjects and Methods It is a case control study in which 200 pregnant women were included, they were divided into 2 equivalent groups:(100 study group) with confirmed rupture of membranes & (100 control group) with intact membranes. Creatinine & urea levels in the vaginal fluid of these pregnant women in all groups were measured. Results The urea cut-off value to diagnose premature rupture of membranes in preterm patient was (16.85 mg/dl) & its cut-off value for diagnosis in term patient was (17.35 mg/dl), while the cut-off value for creatinine to diagnose premature rupture of membranes in both preterm & term patients was (0, 53 mg/dl). Both creatinine & urea sensitivity, specificity, positive & negative predictive values with their accuracy were all 100%. Both creatinine & urea were highly significant for diagnosis of premature rupture of membranes (p-value< 0.001). Conclusion: creatinine & urea levels in the vaginal fluids can be used for the diagnosis of ruptured membranes.