The Value of Detecting Creatinine and Human Chorionic Gonadotropin (Hcg) Levels in Cervicovaginal Discharge in Identifying Leakage in Pregnant Women 24 to 37 Weeks with Clear Leakage or Positive Fern Test
Value of Detecting Creatinine and Hcg Levels in Cervicovaginal Discharge in Identifying Leakage in Pregnant Women
DOI:
https://doi.org/10.31661/gmj.v14i.3693Keywords:
Preterm Rupture of Membranes (PROM); Creatinine; Human Chorionic Gonadotropin (HCG)Abstract
Background: Premature birth is one of the most important midwifery problems, and its early diagnosis is essential in the treatment and prevention process. Therefore, the purpose of this study is the value of detecting the level of creatinine and human chorionic gonadotropin (HCG) in cervicovaginal secretions in detecting discharge in pregnant women of 24 to 37 weeks with clear discharge or a positive Fern test in Forghani Hospital in 2022. Materials and methods: This study was conducted on 230 pregnant women from 24 to 37 weeks suspected of having vaginal discharge. In all suspected women, the creatinine and HCG levels of cervicovaginal secretions were measured, and the results were analyzed based on clear discharge and Fern's test, then the diagnostic power was calculated based on Rock's curve. Results: Our study's findings showed that the average levels of creatinine and B-HCG in women with clear discharge or a positive Fern test were significantly higher than in other women. However, by examining the diagnostic accuracy, it was found that the degree of agreement between the two tests in diagnosing discharge Clear and positive Fern test is weak to moderate, and creatinine has high sensitivity and B-HCG has high specificity. Conclusion: Creatinine and BHCG can be used in the diagnosis of premature rupture along with standard tests, and due to the use of a valuable diagnostic method, the fatal complications of PROM can be prevented, and with the timely treatment of this complication, the dangerous consequences are reduced, a study with higher sample volume and careful control of confounders is required.
References
FG C. Cesarean section and postpartum hysterectomy. Williams Obstetrics. 2001.
Guvenal T, Kantas E, Erselcan T, Culhaoglu Y, Cetin A. Beta-human chorionic gonadotropin and prolactin assays in cervicovaginal secretions as a predictor of preterm delivery. International Journal of Gynecology & Obstetrics. 2001;75(3):229-34.
https://doi.org/10.1016/S0020-7292(01)00495-7
PMid:11728482
Jeong H, Han S-j, Yoo H-N, Choi S-J, Oh S-Y, Kim Y-J, et al. Comparison of changes in etiologic microorganisms causing early-onset neonatal sepsis between preterm labor and preterm premature rupture of membranes. The Journal of Maternal-Fetal & Neonatal Medicine. 2015;28(16):1923-8.
https://doi.org/10.3109/14767058.2014.972928
PMid:25283852
Sim WH, Júnior EA, Costa FDS, Sheehan PM. Maternal and neonatal outcomes following expectant management of preterm prelabour rupture of membranes before viability. Journal of perinatal medicine. 2017;45(1):29-44.
https://doi.org/10.1515/jpm-2016-0183
PMid:27780154
Mariona FG, Cabero L. Are we ready for a new look at the diagnosis of premature rupture of membranes? The Journal of Maternal-Fetal & Neonatal Medicine. 2012;25(4):403-7.
https://doi.org/10.3109/14767058.2011.581715
PMid:21627549
Ashmawy N, Shdeed A, Abd EL-Azeem A, Ebied S. Human Chorionic Gonadotropin Assay in Cervicovaginal Secretions as a Predictor of Preterm Delivary. Benha Journal of Applied Sciences. 2020;5(8 part (1)-(2)):61-5.
https://doi.org/10.21608/bjas.2020.137592
Kafali H, Öksüzler C. Vaginal fluid urea and creatinine in diagnosis of premature rupture of membranes. Archives of gynecology and obstetrics. 2007;275:157-60.
https://doi.org/10.1007/s00404-006-0240-1
PMid:16967274
Rogers LC, Scott L, Block JE. Accurate Point-of-Care Detection of Ruptured Fetal Membranes: Improved Diagnostic Performance Characteristics with a Monoclonal/Polyclonal Immunoassay. Clin Med Insights Reprod Health. 2016;10:15-8.
https://doi.org/10.4137/CMRH.S38386
PMid:27199579 PMCid:PMC4862745
Garg A, Jaiswal A. Evaluation and management of premature rupture of membranes: a review article. Cureus. 2023;15(3).
https://doi.org/10.7759/cureus.36615
Feduniw S, Pruc M, Ciebiera M, Zeber-Lubecka N, Massalska D, Zgliczynska M, et al. Biomarkers for pregnancy latency prediction after preterm premature rupture of membranes-a systematic review. International Journal of Molecular Sciences. 2023;24(9):8027.
https://doi.org/10.3390/ijms24098027
PMid:37175733 PMCid:PMC10178250
Kariman N, Afrakhte M, Hedayati M, Fallahian M, Alavi Majd H. Diagnosis of premature rupture of membranes by assessment of urea and creatinine in vaginal washing fluid. Iran J Reprod Med. 2013;11(2):93-100.
Khudhair ZM, Adnan E. Vaginal Fluid Urea and Creatinine in the Diagnosis of Premature Rupture of Membranes. HIV Nursing. 2022;22(2):1109-11--11.
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. The Journal of Maternal-Fetal & Neonatal Medicine. 2004;15(2):120-5.
https://doi.org/10.1080/14767050410001659842
PMid:15209120
Zanjani MS, Haghighi L. Vaginal fluid creatinine for the detection of premature rupture of membranes. Journal of Obstetrics and Gynaecology Research. 2012;38(3):505-8.
https://doi.org/10.1111/j.1447-0756.2011.01692.x
PMid:22353359
Begum J, Samal SK, Ghose S, Niranjan G. Vaginal fluid urea and creatinine in the diagnosis of premature rupture of membranes in resource limited community settings. Journal of family & reproductive health. 2017;11(1):43.
Gezer C, Ekin A, Golbasi C, Kocahakimoglu C, Bozkurt U, Dogan A, et al. Use of urea and creatinine levels in vaginal fluid for the diagnosis of preterm premature rupture of membranes and delivery interval after membrane rupture. The Journal of Maternal-Fetal & Neonatal Medicine. 2017;30(7):772-8.
https://doi.org/10.1080/14767058.2016.1188072
PMid:27160546
Gurbuz A, Karateke A, Kabaca C. Vaginal fluid creatinine in premature rupture of membranes. International Journal of Gynecology & Obstetrics. 2004;85(3):270-1.
https://doi.org/10.1016/j.ijgo.2003.09.012
PMid:15145264

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