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VOLUME 16 , ISSUE 4 ( July-August, 2024 ) > List of Articles

Original Article

Detection of PROM with Vaginal Fluid Creatinine Levels: A Prospective Case–Control Study

Anubha Kataria, Rajiv K Saxena, Sweta Choudhary, Krithika Krishna

Keywords : Amniotic fluid index, Chorioamnionitis, Prelabor rupture of membrane, Preterm prelabor rupture of membrane, Vaginal fluid creatinine

Citation Information : Kataria A, Saxena RK, Choudhary S, Krishna K. Detection of PROM with Vaginal Fluid Creatinine Levels: A Prospective Case–Control Study. J South Asian Feder Obs Gynae 2024; 16 (4):373-377.

DOI: 10.5005/jp-journals-10006-2449

License: CC BY-NC 4.0

Published Online: 09-07-2024

Copyright Statement:  Copyright © 2024; The Author(s).


Abstract

Aim and background: It is imperative to achieve precise diagnosis of prelabor rupture of membranes (PROM) and preterm prelabor rupture of membranes (PPROM) by recognizing specific amniotic fluid indicators in vaginal environment. The study included assessment of creatinine levels in vaginal fluid along with determining its cut-off value to diagnose PROM/PPROM. Methods: Sixty women with singleton pregnancy of 28 weeks or more period of gestation, were enrolled in the study to be categorized in two equal groups of 30 each. Study group comprised of patients having confirmed PROM and control group included pregnant women with intact membranes. Vaginal fluid samples were collected in a sterile syringe in study patients. In controls, 5 mL of normal (0.9%) saline was instilled into vaginal cavity, and 3 mL of vaginal fluid was collected to be sent for creatinine estimation. Results: The mean value of levels of creatinine in vaginal fluid in study groups was (1.15 ± 0.55 mg/dL) and control groups was (0.15 ± 0.16 mg/dL) showing a significant difference (p < 0.001). The value of creatinine in vaginal fluid to detect PROM/PPROM was 0.7 mg/dL, with sensitivity of 86.67% and specificity of 100%. The positive predictive value (PPV) was 100% and negative predictive value (NPV) was 88.24% with an accuracy of 93.33%. Conclusion: Creatinine estimation in vaginal fluid is an easy, reliable, as well as readily available method to diagnose PROM/PPROM. Clinical significance: Accurate diagnosis of PROM/PPROM, using an easily available and reliable method is important to guide the clinical management in high-risk pregnancy.

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