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Vaginal Fluid Creatinine Levels to Detect Rupture of Membranes.

Palugula Sushma Sree1, E Gomathy1, R K Saxena2

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Vaginal fluid creatinine testing accurately diagnoses rupture of membranes (ROM) with high sensitivity and specificity. This quick, easy method offers reliable results for pregnant women experiencing suspected membrane rupture.

Keywords:
PROMROMVaginal fluid creatininepPROM

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Area of Science:

  • Obstetrics and Gynecology
  • Clinical Chemistry
  • Diagnostic Medicine

Background:

  • Rupture of membranes (ROM) is a critical obstetric event.
  • Preterm premature rupture of membranes (PPROM) and pre-labour ROM require accurate diagnosis.
  • Current diagnostic methods for ROM can be invasive or have limitations.

Purpose of the Study:

  • To evaluate the diagnostic utility of vaginal fluid creatinine levels for ROM.
  • To determine the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of this test.

Main Methods:

  • A prospective comparative study included 60 pregnant women (28-40 weeks gestation).
  • Vaginal fluid samples were collected from 30 women with suspected ROM (case group) and 30 without ROM (control group).
  • Creatinine levels were measured in vaginal fluid samples, with saline instillation used in controls to obtain samples.

Main Results:

  • Mean vaginal fluid creatinine levels were significantly higher in the case group (1.50 ± 0.25 mg/dL) compared to the control group (0.52 ± 0.28 mg/dL).
  • A cutoff score of 1.050 mg/dL demonstrated high diagnostic accuracy.
  • The test achieved 93.1% sensitivity, 90.3% specificity, 90.0% PPV, and 93.3% NPV.

Conclusions:

  • Vaginal fluid creatinine level estimation is a rapid, simple, and accurate method for diagnosing ROM.
  • The test exhibits excellent sensitivity, specificity, PPV, and NPV, making it a valuable diagnostic tool.