Ghasemi Marzieh, Jaami Reyhaneh, Alleyassin Ashraf, Ansarimoghaddam Alireza
Zahedan University of Medical Sciences, Reproductive Health Research Center, Zahedan, Iran.
Zahedan University of Medical Sciences, Ali-Ibn Abitaleb Hospital, Clinic of Obstetrics and Gynecology, Zahedan, Iran.
Turk J Obstet Gynecol. 2016 Jun;13(2):62-66. doi: 10.4274/tjod.48902. Epub 2016 Jun 15.
To evaluate the effectiveness of urea, creatinine, prolactin, and the beta sub-unit of human chorionic gonadotropin (β-hCG) of vaginal fluid in the diagnosis premature preterm rupture of membranes (PROM).
In this observational study, 160 pregnant women with gestational age of 28 to 40 weeks were divided into two equal groups: investigation (documented PROM) and control (intact membrane) groups. Five cubic centimeters of normal saline was poured into the vagina of all participants and the liquid was extracted after a few minutes using a syringe. The liquid was sent to a laboratory for examination. Data were analyzed using a t-test.
The volume of urea, creatinine, prolactin, and β-hCG was significantly different in the two groups (p<0.001). Based on receiver operating characteristic curve and cut-off point, sensitivity, specificity, positive and negative predictive values of β-hCG for detecting PROM were 87.5%, 86%, 86.4%, and 87.3%, respectively. Also, the same factors for urea in detecting PROM were 79.7%, 82.5%, 81.8%, and 80.4%, respectively. Creatinine had 74.6% sensitivity, 85% specificity, and 83% and 77.2% positive and negative predictive values for detecting PROM. Finally, prolactin had 87.5% sensitivity, 90% specificity, and 90% positive and 88% negative predictive values for detecting PROM.
Prolactin and β-hCG have more diagnostic value than urea and creatinine in detecting PROM, and can be used in suspected cases.
评估阴道液中尿素、肌酐、催乳素及人绒毛膜促性腺激素β亚基（β-hCG）在诊断早产胎膜早破（PROM）中的有效性。
在这项观察性研究中，160例孕周为28至40周的孕妇被分为两组，每组人数相等：研究组（确诊为PROM）和对照组（胎膜完整）。向所有参与者的阴道内注入5立方厘米生理盐水，几分钟后用注射器抽取液体。将液体送至实验室进行检查。采用t检验分析数据。
两组中尿素、肌酐、催乳素及β-hCG的含量存在显著差异（p<0.001）。根据受试者工作特征曲线及截断点，β-hCG检测PROM的敏感性、特异性、阳性预测值和阴性预测值分别为87.5%、86%、86.4%和87.3%。同样，尿素检测PROM的上述指标分别为79.7%、82.5%、81.8%和80.4%。肌酐检测PROM的敏感性为74.6%，特异性为85%，阳性预测值和阴性预测值分别为83%和77.2%。最后，催乳素检测PROM的敏感性为87.5%，特异性为90%，阳性预测值为90%，阴性预测值为88%。
在检测PROM方面，催乳素和β-hCG比尿素和肌酐具有更高的诊断价值，可用于疑似病例。
