To Evaluate The Value Of Vaginal Washing Fluid β-HCG And Creatinine For The Clinical Diagnosis Of Premature Rupture Of Membranes

Objective:To evaluate the reliability of vaginal washing fluidβ-HCG and creatinine for the diagnosis of premature rupture of membranes and to find a more ideal marker for the diagnosis of suspected PROM.Methods:A total of 60 term-pregnancy woman complaining vaginal fluid gushing out were recruited for the Study.According to the diagnostic criteria of PROM,they were divided into two groups:PROM group and unconfirmed PROM group.Meanwhile 30 normal term-pregnancy woman were chosen as control group.All women underwent speculum examination aiming to sampleβ-HCG and creatinine in the vaginal washing fluid.When the vaginal washing fluidβ-HCG and creatinine were sampled and immediately sented to the laboratory.The electrochemoluminescence(ECLIA) method was used for quantitative measurement of theβ-HCG and the speed-rate colorimetry method was used for quantitative measurement of the creatinine. Placental tissues of PROM and unconfirmed PROM pregnancy woman were examined histologically,The chance of chorioamnionitis was observed.The results were analyzed using one-way ANOVA test,scheffe multiple comparison test, chi-square test,t test,receiver operating characteristic curve and processed by SPSS 13.0.There was a statistical significance when P＜0.05.Results:There was no significant difference among the PROM group,the unconfirmed PROM and control group in maternal age and gestational age.The mean vaginal washing fluidβ-HCG level in PROM group,unconfirmed PROM group and control group were 441.969±322.262mIU/ml,30.762±43.846mIU/ml,14.299±14.553mIU/ml,respectively,where the difference was statistically significant (P＜0.05).The sensitivity,specificity,negative predictivity and positive predictivity were 85.7%,80.0%,80.0%,85.7%in detecting PROM by evaluation of vaginal washing fluidβ-HCG concentration with a cut-off value of 36.4 mIU/ml.The mean vaginal washing fluid creatinine concentration of PROM group were 1.163±0.706mg/dl,found higher against the unconfirmed PROM group, 0.393±0.517 mg/dl,and control group,0.301±0.620mg/dl.The sensitivity,specificity, negative predictivity and positive predictivity were 78.5%,80.0%,72.7%,84.6%in detecting PROM by evaluation of vaginal washing fluid creatinine concentration with a cut-off value of 0.68 mg/dl.There was no significant difference between the value of quantitative determination of vaginal washing fluidβ-HCG and creatinine concentration for diagnosing PROM(P＞0.05).The chance of chorioamnionitis in PROM group is higher than the chance of chonoamnionitis in unconfirmed PROM group(P＜0.05).The concentration of vaginal washing fluidβ-HCG and creatinine was not increased with elongation of interval time of ruptured membranes(P＞0.05). when the membranes ruptured time is more than 12 hours and the ratio is 57.14%, when less than 12 hours and the ratio is 9.10%,there was significant difference (P＜0.05).Conelusion:1 To evalue the concentration of vaginal washing fluidβ-HCG and creatinine are valuable in the diagnosis of premature rupture of membranes,and through ROC curve analysis,there are no significant difference between them in detecting PROM.2 The chance of chorioamnionitis in PROM group is higher than the chance of chorioamnionitis in unconfirmed PROM group,and the chance of chorioamnionitis in PROM group was increased with the elongation of membrane ruptured time.3 The level ofβ-HCG and creatinine in vaginal washing fluids didn't differ significantly between more than and less than 12 hours of ruptured membranes.