Role of vaginal fluid urea and creatinine in diagnosis of premature rupture of membrane

Shweta Somasikta Pani,Rajlaxmi Sarangi,Subhra Samantarey,Siddharth Behera,Manasi Patnaik

doi:10.18231/j.ijogr.2020.084

Abstract

Pre labour rupture of membrane is associated with an increased maternal and perinatal morbidity and mortality. So confirmatory diagnosis is essential before initiating the definitive treatment of PROM.This study was a cross sectional, case control, hospital based study. All pregnant women having gestational age 28 to 42 weeks are divided into 3 groups as per criteria. Each group has 30 pregnant women group 1 and group 2 are the cases studied and group 3 is control group. Data analysis was done by ANOVA test, kurskal Wallis Test. Difference between two groups are analysed using Man whitney’s U test.The level of vaginal fluid urea and creatinine came out to be higher in group 1 (confirmed cases) than group 2 (suspected cases) and group 3 (controls).Detection of urea and creatinine in vaginal fluid is easy, safe and cost effective method to diagnose PROM.

Highlights

Pre labour rupture of membrane is associated with an increased maternal and perinatal morbidity and mortality
The sample size was calculated based on accuracy level of diagnosis of PROM by the measurement of vaginal fluid urea and creatinine and on feasibile
4 our study showed significantly higher value of urea and creatinine in case PROM compared to the control group

Summary

Introduction

Pre labour rupture of membrane is associated with an increased maternal and perinatal morbidity and mortality. Results: The level of vaginal fluid urea and creatinine came out to be higher in group 1 (confirmed cases) than group 2 (suspected cases) and group 3 (controls). Conclusion: Detection of urea and creatinine in vaginal fluid is easy, safe and cost effective method to diagnose PROM. When the membrane ruptures spontaneously before the onset of labour, it is called pre labour rupture of membrane. 1 Spontaneous onset of labour in term PROM is 86% and in PPROM is around 40%. There is no definitive method to diagnose a PROM. Method for diagnosis is mainly from maternal history of watery discharge and on speculum examination seeing pool of amniotic fluid in posterior fornix. The test taken in this studyto confirm leaking is based on the principal that amniotic fluid contain urea and creatinine of fetal urine. Normal vagina does not contain urea and creatinine so only when the membranes rutures urea and creatinine is detected in vagina

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Discussion

Conclusion