Evaluation of Vaginal Fluid b-Human Chorionic Gonadotropin for Diagnosis of Premature Rupture of Membranes

Abstract
Background: Premature rupture of membranes is a com-mon obstetric problem, and assessment of the woman with possible membranes rupture is management issued faced in every day practice. When the fetal membranes rupture occurs, the fetus loses the protection afforded within the amniotic cavity, the chance of fetal infection increases.
Aim of the Work: To detect the reliability of Beta-Human Chorionic Gonadotropin (b-HCG) in vaginal washings of pregnant women for diagnosis of premature rupture of mem-branes.
Methods: A prospective case-study includes 90 pregnant women subdividing into three equal groups (Group A: 30 pregnant women with confirmed premature rupture of mem-branes, Group B: 30 pregnant women with suspected premature rupture of membranes, Group C: 30 apparently healthy preg-nant women without any complaint) for whom sterilized speculum examination for amniotic fluid pooling, nitrazine paper test and measurement of vaginal washing fluid b-HCG were performed.
Results: There was significant differences in mean vaginal washing fluid b-HCG concentration among the three groups, being higher in Group A than the other two groups and the time interval between sampling and delivery was significantly shorter among the other two groups and the optimal cut off value for vaginal washing b-HCG was 68mIU/mL using ROC curve with a sensitivity of 95%, a specificity of 88%, positive and negative predictive values of 93% and 84% respectively. Diagnostic accuracy was 90%.
Conclusion: Detection of vaginal fluid b-HCG is simple, reliable and rapid test for the diagnosis of premature rupture of membranes.