Novel markers for the diagnosis of premature rupture of membrane in pregnancy: urea, creatinine and prolactin of vaginal fluid

Abstract

Objective: To evaluate the effectiveness of urea, creatinine and prolactin of vaginal fluid in the diagnosis premature rupture of membranes (PROM).Materials and Methods: In this prospective study, 200 pregnant women with gestational age of 28 to 36 weeks 6 Days were included in our study and divided into two equal groups: study group comprised of 100 women with history of leaking per vaginum and documented PROM 100 women with intact membrane made the control group. All women underwent per speculum examination and five ml of normal saline was poured into the vagina and the sample was collected after a few minutes, and sent to the laboratory for examination for various markers.Results: The vaginal washing concentration of urea, creatinine and prolactin was significantly different in the two groups (p<0.001). The sensitivity, specificity, positive and negative predictive values of urea in detecting PROM were 79.5%, 82.3%, 81.6%, and 80.2%, respectively. Creatinine had 74.4% sensitivity, 84.8% specificity, and 82.8% and 77.0% positive and negative predictive values for detecting PROM. Prolactin had 87.7% sensitivity, 92.2% specificity, and 90.2% positive and 88.2% negative predictive values for detecting PROM, thus, was the best in predicting PROM.Conclusion: Prolactin has more diagnostic value than urea and creatinine in detecting PROM, and can be used in suspected cases.