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
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.
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