UREA AND CREATININE LEVELS IN VAGINAL FLUID- A RELIABLE MARKER FOR PRELABOUR RUPTURE OF MEMBRANES
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2018, Vol 7, Issue 20
Abstract
BACKGROUND Prelabour rupture of membranes is known to have adverse effect on pregnant women with unfavourable foetal outcome. Failure to identify membrane rupture can result in failure to implement obstetric measures, while false diagnosis can lead to inappropriate interventions. Different tests are described, but there has been no gold standard test for diagnosing PROM. Thus, to find out the test which is rapid, bedside, inexpensive and accurate led to the study for detection of levels of creatinine and urea in the vaginal fluid for diagnosis of PROM. MATERIALS AND METHODS This is a prospective case control study done over a time period of 2 years in a tertiary care institute. Total 160 pregnant women were divided into study and control groups, each of 80. Vaginal fluid washing was collected, urea and the creatinine estimation was done by (GLDH) Kinetic Method and Jaffe’s Method respectively. RESULTS Creatinine at a threshold value of 0.668 mg/dL had a sensitivity, specificity, PPV, NPV and accuracy of 100%, 91.25%, 91.95%, 100% and 95.62% respectively. In the diagnosis of PROM for a threshold value of 9.906 mg/dL for urea, the sensitivity, specificity, PPV, NPV and accuracy were 100%, 92.5%, 93.02%, 100% and 96.25% respectively in the detection of PROM. CONCLUSION We found that determination of urea and creatinine in vaginal fluid is a reliable marker for diagnosing PROM. This is a simple, practical, cost-effective and easily accessible test if incorporated routinely in the low resource setting. This test has the potential of becoming the gold standard test for the diagnosis of PROM.
Authors and Affiliations
Kshama Kedar, Jayant Patil, Suvarna Nimkar
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