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Diagnosis of premature rupture of membranes by assessment of urea and creatinine in vaginal washing fluid

机译:通过评估阴道冲洗液中的尿素和肌酐来诊断胎膜早破

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摘要

>Background: Rupture of fetal membranes can occur at any gestational age. Premature rupture of membranes (PROM) means rupture of fetal membranes before the onset of labor. >Objective: The purpose of this study was to evaluate and compare the reliability of the vaginal washing fluid urea and creatinine for the diagnosis of PROM and to determine cut-off values. >Materials and Methods: A total of 179 pregnant women were recruited. All patients underwent different examinations. These included nitrazine paper test, fern test, amniotic fluid pooling, vaginal washing fluid urea and creatinine sampling. The one group consisted of 126 pregnant women between 14 and 41 weeks of gestation with the complaint of vaginal fluid leakage. Patients who had positive pooling, nitrazine paper test and fern test were considered as confirmed PROM group (group 1). On the other side, patients with pooling (-) and/or nitrazine paper test (-) and/or fern test (-) were taken as suspected unconfirmed PROM cases (group 2). The control group consisted of 53 pregnant women between 14 and 41 weeks of gestation without any complaint or complication. Weconducted one-way ANOVA test on the urea and creatinine measures and post-hoc comparison test. Cut-off value was determined by receiver operating characteristic (ROC) curve. >Results: Vaginal fluid concentrations of urea and creatinine were significantly different between the three groups (p<0.001). The sensitivity, specificity, positive and negative predictive values and accuracy were all 100% in detecting premature rupture of membranes by evaluation of vaginal fluid creatinine concentration with a cut-off value of 0.45 mg/dl, respectively. >Conclusion: This study demonstrates that of two markers investigated creatinine has the higher diagnostic power.
机译:>背景:任何胎龄的胎膜破裂均可发生。胎膜早破(PROM)是指分娩前胎膜破裂。 >目的:本研究的目的是评估和比较阴道冲洗液尿素和肌酐对PROM诊断的可靠性,并确定临界值。 >材料和方法:总共招募了179名孕妇。所有患者均接受了不同的检查。这些包括硝嗪纸测试,蕨类测试,羊水汇集,阴道冲洗液尿素和肌酐采样。一组包括126名孕妇,妊娠期14至41周,阴道分泌液漏出。合并阳性,硝嗪纸试验和蕨类试验阳性的患者被视为确诊的PROM组(第1组)。另一方面,合并(-)和/或硝嗪纸测试(-)和/或蕨类测试(-)的患者被视为疑似未经确诊的PROM病例(第2组)。对照组由53名妊娠14至41周的孕妇组成,没有任何不适或并发症。我们对尿素和肌酐的测定方法进行了单向方差分析,并进行了事后比较试验。临界值由接收器工作特性(ROC)曲线确定。 >结果:三组之间的尿液和肌酐的阴道液浓度显着不同(p <0.001)。通过评估阴道液肌酐浓度的临界值分别为0.45 mg / dl,检测膜过早破裂的敏感性,特异性,阳性和阴性预测值和准确性均为100%。 >结论:这项研究表明,肌酐的两个标记物具有较高的诊断能力。

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