| Objective To evaluate the value of vaginal fluid J3-hCG levels measured by qualitative method and quantitative determination for detecting premature rupture of membranes (PROM); and to study the predictive value of serum ~- bCG levels in poor outcome of PROM. Methods One hundred term-pregnancy patients complaining vaginal fluid gushing out were enrolled for study According to the diagnostic criteria of PROM , they were divided into two groups PROM group and non- PROM group. Fifty normal term- pregnancy women were chosen as controls .The vaginal fluid f3-hCG levels were detected qualitatively by early pregnancy test and measured quantitatively by radioimmunoassy. Vaginal fluid PH were assayed by nitrazine test.The concentrations of serum ~-hCG and c-reactive protein were estimated by radioimmunoassay and immunoprecipitation nephelometric assay respectively. Placental tissues were examined histologically. Perinatal outcome was observed. Results: I .For qualitative measurement of vaginal fluid J3-hCG levels to detect PROM ,sensibitity .specificity. positive predictive value and negative predictive value were 94.20% ..93.55 % ..97.01 %and 87.88 %respectively.There was no statistically significant difference between this measurement and nitrazine test (P>0.05) . 2.When qualitative measurement was combined with nitrazine test for diagnosing PROM, sensibitity was 84.06?/o,specificity 100.00 % , positive predictive value 100.00 % .The specificity was significantly higher than that of nitrazine test alone (P <0.05). 3. There was no significant difference between the value of quantitative determination and that of qualitative detection of vaginal fluid j3-hCO concentrations for diagnosing PROM (P>0.05). 4. The mean of serum f3-hCG levels in PROM patients was 18.32 ?7.66 ng/ml, the median was 16.1 ng/ml. In normal term-pregnancy women, the mean was 13.12?.79 ng/ml, the median was 12.6Ong/ml. The difference was significant statistically(P<0.0 1). 5.The serum f3-hCG levels of PROM patients with infection were significantly higher than that of pregnant wowen without infection (23.23 ?8.66 ng/ml VS 16.85 ?7.22ng/ml,P < 0.05) . 6. Taking the multiples of the median (MOM) of the serum f3-hCG levels in the normal term- pregnancy women as demarcation ,the incidences of chorioamnionitis and neonate infection in the group of serum j3-hCG levels ~2MOM were significantly higher than those in the control group (P<0.Ol) 7. There were no difference in the incidences of chorioamnionitis and neonate infection between the group of serum f3-hCO levels ~2MOM and the group of c-reactive protein concentrations ~ 1 Omg/L (P >0.05) Conclusion The qualitative and quantitative measurements of vagina fluid 13-hCG levels were good methods for diagnosing PROM , especially the qualitative method (early pergnancy test ). The value of qualitative measurement of vagina fluid ~-hCG levels was equal to that of nitrazine test for diagnosing PROM . When combining the qualitative measurement with nitrazine test, specificity rised significantly, and that was suitable to diagnose the cases of equivocal PROM especially .When the serum 13-hCG levels of PROM patients were ~ 2MOM, the incidences of chorioamnionitis and neonate infection rised significantly. It suggests that maternal serum 13-hCG levels may be served as a valuable clinical index for identificatiing infection in PROM patients .Further studies are needed to confirm the mechanism between f3-hCG levels and placental pathologic... |
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