DETECTION OF PREMATURE RUPTURE OF MEMBRANES WITH THE HELP OF VAGINAL FLUID CREATININE IN PATIENTS ADMITTED AT GUJARAT ADANI INSTITUTE OF MEDICAL SCIENCE, BHUJ, GUJARAT, INDIA- A OBSERVATIONAL STUDY

Dr. Tarak Nath Mukherjee and Dr. Nagajan Bhadarka

ABSTRACT

Aim: The aim of present study was to estimate the reliability of vaginal fluid creatinine for the analysis of premature rupture of membranes. Material and Methods: A total of 180 pregnant women were recruitedin the study. Group I (confirmed group) consisted of 60 women with a diagnosis of rupture of membranes established by visualization of fluid passing from the cervical canal. Group II (suspected group) consisted of 60 women with a complaint of vaginal fluid escape but without clear amniotic fluid flowing from the cervix or vaginal pooling with negative nitrazine test. The control group (group III) consisted of 60 women without any complaint or complication. All patients were sampled for vaginal fluid creatinine by speculum examination. One-way ANOVA, c2, and Kruskal-Wallis test, as well as receiver operating characteristic (ROC) curve analysis were used. Analysis was done with SPSS version 15. The level of significance was set at 0.05 and confidence interval was set at 95%. Results: The mean vaginal fluid creatinine in groups I, II, and III were 1.74 ± 0.8, 0.45 ± 0.2 and 0.25 ± 0.1 mg/dL, respectively. The creatinine level was significantly superior in the confirmed group (group I) than in the other two groups (P < 0.001). The optimal cut-off value was 0.5 mg/dL with 96.7% sensitivity, 100% specificity, 100% positive predictive value, and 96.8% negative predictive value. Conclusion: Vaginal fluid creatinine determination for the diagnosis of PROM is reliable, simple, rapid and inexpensive.

Keywords: Creatinine, Diagnosis, Vaginal fluid, Women.