The Evaluation Of Diagnostic Role Of Vaginal Fluid Urea, Creatinine And Β-HCG Level For Detection Of Premature Rupture Of Membrane.

10.5580/120 ◽  
2011 ◽  
Vol 15 (1) ◽  
Keyword(s):  
Vaginal Fluid ◽  
Premature Rupture ◽  
Diagnostic Role ◽  
Β Hcg

Practicability of using vaginal fluid markers in detecting premature rupture of membranes

2003 ◽  
Vol 40 (5) ◽  
pp. 542-545 ◽  
Author(s):  
Chen Yi Ni ◽  
Wang Xue Jia ◽  
Wu Min Yi ◽  
Lu Hai Feng ◽  
Lin Zhi Yu
Keyword(s):  
Sensitivity And Specificity ◽  
Roc Analysis ◽  
Random Access ◽  
Diagnostic Sensitivity ◽  
Vaginal Fluid ◽  
Emergency Setting ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Β Hcg ◽  
Diagnostic Sensitivity And Specificity

Background: Premature rupture of membranes (PROM) may cause intra-uterine infection and fetal death. A diagnostic tool that is non-invasive, specific and quick is needed to predict PROM. Human chorionic gonadotrophin (hCG), α-fetoprotein (AFP) and interleukin 6 (IL-6), which are present in vaginal fluid, were reported to be potential markers for PROM but have not yet been used in the clinic. This study was designed in a daily routine semi-emergency setting to evaluate the clinical practicability of using these markers in diagnosing PROM. Methods: Using a random-access automated luminescence immunoassay system, 81 vaginal washing samples collected from third trimester pregnant women (43 from PROM patients, 38 from patients with intact membranes) were analysed for β-hCG, AFP and IL-6 in a semi-emergency setting. The Mann-Whitney U-test was used to test the difference between the two groups. Receiver operator curve (ROC) analysis was used to evaluate the performance of the three markers and to determine the cut-off value for a positive diagnosis. Results: Vaginal fluid concentrations of the three markers were significantly different ( P < 0.001) between the two groups. ROC analysis indicated that AFP had a 97.7% diagnostic sensitivity and 100% specificity; the other two markers had lower diagnostic sensitivity and specificity (95.3% and 89.5% for β-hCG and 83.7% and 78.9% for IL-6, respectively). Discussion: This work demonstrates that, of the three markers investigated, AFP has the highest diagnostic sensitivity and specificity. Using the 'stat' function provided by the automated luminescence immunoassay system, the reporting time of the results was less than 1h. We conclude that vaginal fluid AFP measured by random-access automated luminescence immunoassay is an ideal marker for the diagnosis of PROM. The technique could be introduced into the laboratory as a semi-emergency service to meet clinical needs.

scholarly journals Qualitative Determination of Human Chorionic Gonadotropin in Vaginal Washings for the Early Diagnosis of Premature Rupture of Fetal Membranes

2017 ◽  
Vol 39 (07) ◽  
pp. 317-321
Author(s):  
Camila Dartibale ◽  
Nelson Uchimura ◽  
Luiz Nery ◽  
Angelita Schumeish ◽  
Liza Uchimura ◽  
...  
Keyword(s):  
Early Diagnosis ◽  
Pregnant Women ◽  
Chorionic Gonadotropin ◽  
Human Chorionic Gonadotropin ◽  
Fetal Membranes ◽  
Vaginal Fluid ◽  
Premature Rupture ◽  
Significant Difference ◽  
Β Hcg ◽  
Hcg Test

Purpose This study aimed to evaluate and validate the qualitative human chorionic gonadotropin β subunit (β-hCG) test of the vaginal fluid washings of pregnant women with premature rupture of fetal membranes (PROM). Methods Cross-sectional study of pregnant women between gestational weeks 24 and 39 who underwent consultations in one of our institutions. They were divided into two groups: group A (pregnant women clinically diagnosed with PROM) and group B (pregnant women without loss of amniotic liquid). The patients were subjected to a vaginal fluid washing with 3 mL of saline solution, which was aspirated subsequently with the same syringe. The solution was immediately sent to the laboratory to perform the vaginal β-hCG test with cut-off points of 10 mIU/mL (β-hCG-10) and/or 25 mIU/mL (β-hCG-25). Results The β-hCG-10 test of the vaginal secretion was performed in 128 cases. The chi-squared test with Yates' correction showed a statistically significant difference between the 2 groups (p = 0.0225). The sensibility, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy parameters were 77.1%, 43.6%, 52.3%; 70.4%; and 58.6% respectively. The β-hCG-25 test of the vaginal washing was performed in 49 cases. The analysis by Fisher's exact test showed a statistically significant difference between the groups (p = 0.0175). The sensibility, specificity, PPV, NPV, and accuracy parameters were 44.4%, 87.1%, 66.6%; 72.9%; and 71.4% respectively. Conclusions The β-hCG-25 test showed better accuracy for the diagnosis of PROM, and can corroborate the early diagnosis of PROM because it is a simple and quick exam.

scholarly journals The value of measurement of vaginal fluid creatinine and beta-human chorionic gonadotropin in the diagnosis of premature rupture of membranes

2021 ◽  
Author(s):  
Zafer Bütün
Keyword(s):  
Predictive Value ◽  
Accurate Method ◽  
Control Group ◽  
Lower Sensitivity ◽  
Vaginal Fluid ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Beta Human Chorionic Gonadotropin ◽  
Significant Difference ◽  
Β Hcg

Objective: The purpose of the present study is to evaluate β-human chorionic go- nadotropin (β-hCG) and creatinine levels in the vaginal fluid regarding to diagnosis of premature rupture of membranes (PROM). Material and Methods: This study was conducted on 150 pregnant women in the third trimester (28–40 weeks). The patients were grouped as: (1) PPROM group (75 cases) and (2) intact membranes as control group (75 cases). Three milliliters of ster- ile normal saline were inserted into the posterior fornix of the vagina and then vaginal fluid was aspirated. Creatinine and β-hCG levels in the vaginal fluid were measured β-hCG and creatinine levels were compared between the two groups. Results: The mean vaginal fluid level in Groups 1 and 2 was 0.60±0.72 (0.37) and 0.22±0.11 (0.2) for creatinine and β-hCG which was positive in 411.69±605.65 (146) and 12.71±24.63 (3.9), respectively. There was a statistically significant difference regarding to mean creatinine and β-hCG levels between two groups (p<0.001). Sen- sitivity, specificity, positive predictive value, negative predictive value, and accuracy were all 66.67%, 96%, 94.3%, 74.3%, and 81.3% for creatinine and 94.6%, 82.6%, 84.52%, 93.94%, and 88.67% for β-hCG in detecting PROM with a cutoff value of 0.21 mg/dl for creatinine and 16 mIU/ml for β-hCG. Conclusion: Measuring of β-hCG level in vaginal fluid is accurate, cheap, and simple methods in the diagnosis of PROM. Furthermore, measuring of creatinine level is a simple and accurate method with a lower sensitivity and accuracy than for β-hCG.

scholarly journals Role of vaginal fluid urea and creatinine in diagnosis of premature rupture of membrane

2020 ◽  
Vol 7 (3) ◽  
pp. 398-401
Author(s):  
Shweta Somasikta Pani ◽  
◽  
Manasi Patnaik ◽  
Rajlaxmi Sarangi ◽  
Subhra Samantarey ◽  
...  
Keyword(s):  
Vaginal Fluid ◽  
Premature Rupture

scholarly journals PREMATURE RUPTURE OF MEMBRANES

2018 ◽  
Vol 25 (02) ◽  
pp. 168-172
Author(s):  
Azmeena Azam ◽  
Hafiz Maoz Husnain ◽  
Iqra Marryum
Keyword(s):  
Cross Sectional Study ◽  
Chorionic Gonadotrophin ◽  
Human Chorionic Gonadotrophin ◽  
Vaginal Fluid ◽  
Effective Management ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Cross Sectional ◽  
Β Hcg ◽  
Hcg Test

Background: Pre-labour rupture of the membranes is one of the most commonclinical presentations in an obstetric setting. Early diagnosis is a major challenge faced byevery obstetrician and key to effective management and prevention of complications. As aresult of PROM, amniotic fluid that provides protection to the developing fetus is lost, exposingit to the outside environment. β-hCG is a hormone secreted by syncytiotrophoblasts found inamniotic fluid that can be studied for the evaluation of PROM. Objectives: To find the DiagnosticAccuracy of β human chorionic gonadotrophin test in vaginal washings taking amniotic fluidpooling as gold standard of diagnosing PROM. Study Design: Cross-sectional study. Setting:Unit II, Department of Obstetrics & Gynecology, Lahore General Hospital, Lahore. Period: Threemonths from January 2017 to March 2017. Material and methods: Females of age 18-40 yearswith gestational age >36weeks (calculated by LMP) complaining of PV leaking were includedin the study. Samples for β-hCG measurements were taken after informed consent. A β-hCGkit (Acu-check) was used for detection of β-hCG in vaginal fluid washings of pregnant women.Results: Diagnostic accuracy of β-hCG test was 91.66%. Sensitivity and specificity of β-hCGtest was 86.66% and 96.66%. Positive predictive and negative predictive value was 96.29% and87.87% respectively. Conclusion: Results of this study showed that for diagnosis of patientshaving PROM, beta human chorionic gonadotrophin (β-hCG) is a reliable, easy and quick test.

scholarly journals The diagnostic role of the β-hCG discriminatory zone combined with the endometrial pattern for ectopic pregnancy in Chinese women

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Qi Lu ◽  
Yiwei Wang ◽  
Xiao Sun ◽  
Yuhong Li ◽  
Jing Wang ◽  
...  
Keyword(s):  
Ectopic Pregnancy ◽  
Chinese Women ◽  
Endometrial Thickness ◽  
Transvaginal Ultrasound ◽  
Diagnostic Value ◽  
Wide Range ◽  
Endometrial Pattern ◽  
Diagnostic Role ◽  
Β Hcg

Abstract Previous studies have regarded the discriminatory serum β-hCG zone (DSZ) as a valuable tool for the diagnosis of ectopic pregnancy (EP). However, the wide range of the DSZ makes achieving a clinical diagnosis of EP difficult, and these reports do not indicate whether the DSZ is suitable for an EP diagnosis in Chinese women. Several studies have indicated that the endometrial pattern in patients with EPs is different from that in patients with intrauterine pregnancies (IUPs). The aims of this study were to define the DSZ cutoff value for Chinese women, test whether the endometrial pattern is a suitable predictor for EP, and assess the diagnostic value of these indicators. We enrolled participants with IUPs or EPs with abdominal pain and/or vaginal bleeding, and serum β-hCG level measurements and transvaginal ultrasound (TVS) were performed to assess the diagnostic value of the indicators for EP. The sensitivity and specificity for identifying an EP were improved by combining the DSZ, endometrial thickness and trilaminar pattern indexes. The results of this study might be helpful toward providing further options for the diagnosis of EP, especially for patients without hemoperitoneum or colporrhagia.

Role of Serum β-HCG doubling in Diagnosis of Early Pregnancy and its Management Strategy

2020 ◽  
Vol 16 ◽  
Author(s):  
Divya Mirji ◽  
Shubha Rao ◽  
Akhila Vasudeva ◽  
Roopa P.S
Keyword(s):  
Ectopic Pregnancy ◽  
Early Pregnancy ◽  
Management Strategy ◽  
Transvaginal Ultrasound ◽  
Expectant Management ◽  
First Trimester ◽  
Intrauterine Pregnancy ◽  
Β Hcg ◽  
Pregnancy Of Unknown Location

Background: Pregnancy of unknown location (PUL) is defined as the absence of intrauterine or extrauterine sac and Beta Human Chorionic Gonadotropin levels (β-HCG) above the discriminatory zone of 1500 mIU/ml. It should be noted that PUL is not always an ectopic; however, by measuring the trends of serum β-HCG, we can determine the outcome of a PUL. Objective: This study aims to identify the various trends β-HCG levels in early pregnancy and evaluate the role of β-HCG in the management strategy. Methods: We conducted a prospective observational study of pregnant women suspected with early pregnancy. Cases were classified as having a pregnancy of unknown location (PUL) by transvaginal ultrasound and ß-HCG greater than 1000 mIU/ml. Expectant management was done until there was a definite outcome. All the collected data were analyzed by employing the chi-square test using SPSS version 20. Results: Among 1200 women who had early first trimester scans, 70 women who fulfilled our criteria of PUL and ß-HCG > 1000 mIU/ml were recruited in this study. In our study, the mean age of the participants was 30±5.6yrs, and the overall mean serum ß-HCG was 3030±522 mIU/ml. The most common outcome observed was an ectopic pregnancy, 47% in our study. We also found the rate of failing pregnancy was 27%, and that of intrauterine pregnancy (IUP) was 25%. Overall, in PUL patients diagnosed with ectopic pregnancy, 9% behaved like IUP, and 4% had an atypical trend in their ß-HCG. Those who had an IUP, 11% had a suboptimal increase in ß-HCG. Conclusion: PUL rate in our unit was 6%. Majority of the outcome of PUL was ectopic in our study. Every case of PUL should be managed based on the initial ß-HCG values, clinical assessments and upon the consent of the patient.

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