Urea and Creatinine Levels in Vaginal Fluid as a Predictor for Length of Latency Period in Prelabour Membranes Rupture

Abstract

Background: The diagnosis of equivocal cases of prelabour rupture of membranes (PROM) with traditional methods has been unreliable therefore various biochemical markers have been sought to confirm the same, this study aims to determine the relation between the concentration of urea and creatinine in vaginal fluid and length of latency period in women with PROM between 32 and 35 weeks gestation. Methods: sixty patients were included in our study with PROM of their singleton pregnancies, their gestational age ranged between 32- 35 gestational weeks by reliable menstrual history and confirmed by pelvi-abdominal ultrasound. All samples were obtained within 6 hours after membranes rupture before vaginal examination and the administration of any drugs All women will be put under observation for 48 hours and time of onset of delivery will be documented, the onset of labor will be diagnosed by either: frequent uterine contractions more than 2 contractions in 10 minutes or CTG showing frequent contractions. Results: The current study was conducted on a total number of 60 pregnant women, 20-35 year old; pregnant between 32 and 35weeks. Our study demonstrated that patients with higher levels of vaginal fluid urea and creatinine concentrations had earlier onset of labor. Patients with vaginal fluid urea and creatinine concentrations above cut-off levels (urea ≥26.0 (mg/dL), creatinine ≥0.64 (mg/dL)) went into labor early within a 48 hours latency period. This suggests vaginal urea and creatinine levels measurement in the prediction of early delivery. Conclusion: Measurement of urea and creatinine in vaginal fluid is a cheap and rapid method with high sensitivity and specificity for the delivery interval after PROM. Therefore, these methods can be integrated as non-invasive tests for the predication of delivery interval after PROM.