Quantitative and Qualitative Measurement of Vaginal Fluid β-HCG for the Diagnosis of Premature Rupture of Membranes

Document Type : Original Article

Authors

1 Department of Obstetrics and Gynecology, Ahvaz Jundishapur University of Medical Science, Ahvaz, Iran

2 Department of Obstetrics and Gynecology, Shahid Sadoughi University of Medical Science, Yazd, Iran

Abstract

Background: Premature rupture of membranes (PROM) is known as one of the leading causes of morbidity and mortality among pregnant women. So, the aim of this study was to evaluate the diagnostic value of quantitative and qualitative vaginal fluid β-HCG for the detection of premature rupture of membranes.
Methods: One hundred pregnant women with gestation age between 28 and 37 weeks were divided into three groups: confirmed PROM group (34 cases), suspected of PROM (36 cases), and intact membranes (30 cases). Those pregnant women with positive pooling tests were considered as confirmed PROM, while those with the decreased amniotic fluid index, positive nitrazine, or ferning were included in suspected PROM group. Notably, pregnant women with no complaints or complications were enrolled as the control group. Five ml sterile normal saline was injected into the posterior fornix of vagina, vaginal fluid was aspirated, and β-HCG measurement was then performed both quantitatively and qualitatively using ELISA and baby check kits, respectively.
Results: The cut-off value for quantitative β-HCG was determined as 66 mIU/m. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of quantitative β-HCG were calculated as 97.05%, 100%, 100%, 96.77%, and 98.43%, respectively. Besides, the qualitative vaginal washing fluid β-HCG using Baby check with the threshold value of 25 mIU/ml had 94.11% sensitivity, 93.33% specificity, 94.11% PPV, 93.33% NPV, and 93.75% accuracy.
Conclusion: Quantitative and qualitative vaginal washing fluid
β-HCG measurements are accurate, reliable, and useful tests for the diagnosis of PROM.

Keywords

References

  1. Janku P, Kacerovsky M, Zednikova B, Andrys C, Kolackova M, Drahosova M et al. Pentraxin 3 in noninvasively obtained cervical fluid samples from pregnancies complicated by preterm prelabor rupture of membranes. Fetal Diagn Ther 2019; 46(6): 402-10.
  2. Yu H, Wang X, Gao H, You Y, Xing A. Perinatal outcomes of pregnancies complicated by preterm premature rupture of the membranes before 34 weeks of gestation in a tertiary center in China: A retrospective review. Biosci Trends 2015; 9(1): 35-41.
  3. Esim E, Turan C, Unal O, Dansuk R, Cengizglu B. Diagnosis of premature rupture of membranes by identification of β-HCG in vaginal washing fluid. Eur J Obstet Gynecol Reprod Biol 2003; 107(1): 37-40.
  4. Eldaly A, Omran E, Youssef MA, Abdallah A, Metwally A, Haggag H et al. Use of beta subunit of human chorionic gonadotropin assay as a diagnostic tool for prelabor rupture of membranes. J Matern Fetal Neonatal Med 2019; 32(12): 1965-70.
  5. Abdelazim IA. Insulin‐like growth factor binding protein‐1 (A ctim PROM test) for detection of premature rupture of fetal membranes. J Obstet Gynaecol Res 2014; 40(4): 961-7.
  6. Temel O, Çöğendez E, Selçuk S, Asoğlu MR, Kaya E. β-human chorionic gonadotropin assay in vaginal washing fluid for the accurate diagnosis of premature rupture of membranes during late pregnancy. J Turk Ger Gynecol Assoc 2013; 14(4): 201-4.
  7. Kim YH, Park YW, Kwon HS, Kwon JY, Kim BJ. Vaginal fluid β-human chorionic gonadotropin level in the diagnosis of premature rupture of membranes. Acta Obstet Gynecol Scand 2005; 84(8): 802-5.
  8. Ni CY, Jia WX, Yi WM, Feng LH, Yu LZ. Practicability of using vaginal fluid markers in detecting premature rupture of membranes. Ann Clin Biochem 2003; 40(5): 542-5.
  9. Kashanian M, Hadizadeh H, Faghankhani M, Nazemi M, Sheikhansari N. Evaluating the effects of copper supplement during pregnancy on premature rupture of membranes and pregnancy outcome. J Matern Fetal Neonatal Med 2018; 31(1): 39-46.
  10. Friedman ML, McElin TW. Diagnosis of ruptured fetal membranes: clinical study and review of the literature. Am J Obstet Gynecol 1969; 104(4): 544-50.
  11. Lyons P, McLaughlin N. Premature rupture of membranes. In: Lyons P. Obstetrics in family medicine: A practical guide. 3rd Berlin, Germany: Springer; 2020. p. 65-70.
  12. Carroll S, Papaioannou S, Nicolaides KH. Assessment of fetal activity and amniotic fluid volume in the prediction of intrauterine infection in preterm prelabor amniorrhexis. Am J Obstet Gynecol 1995; 172(5): 1427-35.
  13. van der Ham DP, van Teeffelen AS, Mol BW. Prelabour rupture of membranes: overview of diagnostic methods. Curr Opin Obstet Gynecol 2012; 24(6): 408-12.
  14. Erdemoglu E, Mungan T. Significance of detecting insulin-like growth factor binding protein-1 in cervicovaginal secretions: comparison with nitrazine test and amniotic fluid volume assessment. Acta Obstet Gynecol Scand 2004; 83(7): 622-6.
  15. Kishida T, Yamada H, Negishi H, Sagawa T, Makinoda S, Fujimoto S. Diagnosis of premature rupture of the membranes in preterm patients, using an improved AFP kit: comparison with ROM-check and/or nitrazine test. Eur J Obstet Gynecol Reprod Biol 1996; 69(2): 77-82.
  16. Buyukbayrak E, Turan C, Unal O, Dansuk R, Cengizoğlu B. Diagnostic power of the vaginal washing-fluid prolactin assay as an alternative method for the diagnosis of premature rupture of membranes. J Matern Fetal Neonatal Med 2004; 15(2): 120-5.
  17. Revah A, Hannah ME, Sue-A-Quan AK. Fetal fibronectin as a predictor of preterm birth: an overview. Am J Perinatol 1998; 15(11): 613-22.
  18. Lee SE, Park JS, Norwitz ER, Kim KW, Park HS, Jun JK. Measurement of placental alpha-microglobulin-1 in cervicovaginal discharge to diagnose rupture of membranes. Obstet Gynecol 2007; 109(3): 634-40.
  19. Anai T, Tanaka Y, Hirota Y, Miyakawa I. Vaginal fluid hCG levels for detecting premature rupture of membranes. Obstet Gynecol 1997; 89(2): 261-4.
  20. Beesley R, Trevino N, Smyth M, Gould C, Robinson R. Vaginal fluid human chorionic gonadotropin for detection of rupture of membranes. J Reprod Med 2008; 53(11): 823-6.
  21. Dartibale CB, Uchimura NS, Nery L, Schumeish AP, Uchimura LYT, Santana RG et al. Qualitative determination of human chorionic gonadotropin in vaginal washings for the early diagnosis of premature rupture of fetal membranes. Rev Bras Ginecol Obstet 2017; 39(7): 317-21.
  22. Cooper AL, Vermillion ST, Soper DE. Qualitative human chorionicgonadotropin testing of cervicovaginal washings for the detection of preterm premature rupture of membranes. Am J Obstet Gynecol 2004; 191(2): 593-6.

 

 

World Journal of Peri and Neonatology
Volume 4, Issue 2
December 2021
Pages 70-75

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History

  • Receive Date: 22 January 2022
  • Accept Date: 22 January 2022
  • First Publish Date: 22 January 2022

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