Vaginal fluid creatinine for the detection of premature rupture of membranes

Zanjani, Mansooreh; Haghighi, Ladan

doi:10.1111/j.1447-0756.2011.01692.x

Cited by 20 publications

(17 citation statements)

References 7 publications

(9 reference statements)

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“…Furthermore, in the study in which Zanjani et al [20] confirmed PROM diagnosis in the speculum examination according to the presence of pooling and the nitrazine test result, they found 96.5% sensitivity, 100% specificity, 100% positive predictive value and 96.8% negative predictive value when the cut-off value of creatinine in the vaginal flushing fluid was taken as 0.5 mg/dl. However, the high false positivity rate of nitrazine test in the PROM diagnosis due to the possibility of change in vaginal pH in the presence of blood, semen or infection such as bacterial vaginosis has paved the way for other studies.. Sekhavat et al [16] used fern test and the detection of pooling in the speculum examination to confirm the PROM diagnosis test on the grounds that nitrazine test has a high rate of false positivity.…”

Section: Discussionmentioning

confidence: 98%

“…The study performed by Gürbüz et al [12] also observed the same level to P a g e / S a y f a | 426 be 0.026 (0.029) mg/dl in the group whose water did not break, and 0.70 (0.55) mg/dl in the group whose water broke. It has been suggested in previous studies that the creatinine assessment in vaginal flushing fluid can be used as a marker for diagnosis when PROM is clinically suspected in the speculum examination [12,16,19,20,30]. Firstly, the study conducted by Li Hy et al [29] found that hCG, AFP and creatinine concentrations were high in amniotic fluid.…”

Section: Discussionmentioning

confidence: 99%

“…When the threshold value of creatinine concentration in vaginal flushing fluid was accepted as 0.12 mg/dl in the study conducted by Gürbüz et al [12], and the value of creatinine concentration was accepted as 0.6 mg/dl in the study conducted by Kafalı et al [19], sensitivity, specificity, and positive and negative predictive values were found to be 100% in both studies. A study conducted by Zanjani et al [20] found 96.7% sensitivity, 100% specificity, 100% positive predictive value and 96.8% negative predictive value when the threshold value of creatinine concentration was taken as 0.5 mg/dl. Moreover, creatinine value ranging between 1.5 and 2.0 mg/dl in the amniotic fluid was also observed as a symptom of fetal maturity [21].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Use of vaginal creatinine levels in detecting premature rupture of membranes

Kuruoğlu¹,

Bıldırcın²,

Karli³

et al. 2019

Journal of Surgery and Medicine

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How to cite / Atıf için: Kuruoğlu YS, Bıldırcın FD, Karlı P, Özdemir AZ. Use of vaginal creatinine levels in detecting premature rupture of membranes.This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License 4.0 (CC BY-NC-ND 4.0) where it is permissible to download, share, remix, transform, and buildup the work provided it is properly cited. The work cannot be used commercially without permission from the journal. AbstractAim: Misdiagnosis is frequent in premature rupture of membranes (PROM) patients. The most accurate diagnosis of PROM requires reliable laboratory tests. Due to the lack of a gold-standard diagnostic method, many methods have been proposed in this regard. The aim of this study is to determine an easy diagnostic method in early membrane rupture and to determine the usability, reliability and cut-off values of vaginal creatinine measurements in the detection of PROM compared to vaginal placental alpha microglobulin-1 (PAMG-1) test. Methods: We designed a cross-sectional study. A total of 63 patients admitted to the Obstetrics and Gynecology Clinic of Samsun Ondokuz Mayıs University with suspected PROM between 15 November 2012 and 15 June 2013 were included in this study. Following anamnesis, all patients were vaginally subjected to PAMG-1 (AmniSure® ROM) test with sterile speculum and injected with 5 cc of saline into the vagina, and then, a 3 cc sample was retrieved with the same injector and put into a biochemistry tube. Immediately thereafter, the material was sent to the biochemistry laboratory, centrifuged and stored at -70 0 C until all samples were studied. The patients were classified as PROM and non-PROM based on the positive or negative result of PAMG-1 test. Following this classification, the patients were also grouped as PROM and non-PROM according to their vaginal creatinine values. Results: The mean maternal age of our patients was 26.3 years in the PROM group and 28.8 years in the non-PROM group. The mean gestational weeks were 30.8 weeks in the PROM patients and 32.5 weeks in the non-PROM patients. Of 20 patients subjected to PAMG-1 test for PROM diagnosis, 17 were PAMG-1 and creatinine positive while 3 were PAMG-1 negative and creatinine positive. Of 43 patients subjected to PAMG-1 test, 42 were PAMG-1 negative while 1 was PAMG-1 positive and creatinine negative. Accordingly, vaginal creatinine was found to have 94.4% sensitivity, 93.3% specificity, 85% positive predictive value, and 97.7% negative predictive value in PROM diagnosis. The mean creatinine values in the PROM and non-PROM groups were 0.39 (0.31) mg/dl and 0.04 (0.10) mg/dl, respectively (P=0.05). Conclusion: Creatinine assessment in vaginal flushing fluid can be a cheaper, faster, easily accessible and highly accurate test with 94.4% sensitivity and 93.3% specificity in PROM diagnosis. Öz Amaç: Erken membran rüptürü (EMR) bulunan hastaların teşhisinde yanılgılar sık görülebilmektedir. EMR tanısını en doğru şekilde koymak için güvenilir laboratuvar...

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Use of vaginal creatinine levels in detecting premature rupture of membranes

Kuruoğlu¹,

Bıldırcın²,

Karli³

et al. 2019

Journal of Surgery and Medicine

View full text Add to dashboard Cite

show abstract

“…β-hCG is also a substance produced by trophoblastic tissue, found in different concentrations in maternal blood, urine, and amniotic fluid, and is easy to detect. [13] The presence of these two substances in low concentrations in vaginal secretions and the increase in the concentration in the vagina after amniotic drainage in PROM means that the use of these substances may be appropriate in the diagnosis of PROM. In our study, we investigated the place of β-hCG and creatinine values in vaginal washing fluid in the diagnosis of PROM.…”

Section: Discussionmentioning

confidence: 99%

The value of measurement of vaginal fluid creatinine and beta-human chorionic gonadotropin in the diagnosis of premature rupture of membranes

Bütün¹

2021

Zeynep Kamil Med J

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Objective: The purpose of the present study is to evaluate β-human chorionic go- nadotropin (β-hCG) and creatinine levels in the vaginal fluid regarding to diagnosis of premature rupture of membranes (PROM). Material and Methods: This study was conducted on 150 pregnant women in the third trimester (28–40 weeks). The patients were grouped as: (1) PPROM group (75 cases) and (2) intact membranes as control group (75 cases). Three milliliters of ster- ile normal saline were inserted into the posterior fornix of the vagina and then vaginal fluid was aspirated. Creatinine and β-hCG levels in the vaginal fluid were measured β-hCG and creatinine levels were compared between the two groups. Results: The mean vaginal fluid level in Groups 1 and 2 was 0.60±0.72 (0.37) and 0.22±0.11 (0.2) for creatinine and β-hCG which was positive in 411.69±605.65 (146) and 12.71±24.63 (3.9), respectively. There was a statistically significant difference regarding to mean creatinine and β-hCG levels between two groups (p<0.001). Sen- sitivity, specificity, positive predictive value, negative predictive value, and accuracy were all 66.67%, 96%, 94.3%, 74.3%, and 81.3% for creatinine and 94.6%, 82.6%, 84.52%, 93.94%, and 88.67% for β-hCG in detecting PROM with a cutoff value of 0.21 mg/dl for creatinine and 16 mIU/ml for β-hCG. Conclusion: Measuring of β-hCG level in vaginal fluid is accurate, cheap, and simple methods in the diagnosis of PROM. Furthermore, measuring of creatinine level is a simple and accurate method with a lower sensitivity and accuracy than for β-hCG.

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“…Zanjani and Haghighi analyzed the sensitivity, specificity, PPV, and NPV of varying levels of vaginal fluid creatinine. 5 Lee et al had done a study on the measurement of placental alpha-microglobulin-1 in cervicovaginal discharge to diagnose a ROM. 6 They had observed 184 women of GA 11-42 weeks, ROM was diagnosed in 76% using conventional clinical assessment (nitrazine test) and 88% using placental alpha-microglobulin-1.…”

Section: Discussionmentioning

confidence: 99%

Optimal Level of Vaginal Fluid Creatinine to Detect Rupture of Amniotic Membranes

Vijayaraghavan¹,

Ramasamy²

2020

Journal of South Asian Federation of Obstetrics and Gynaecology

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Aim:To estimate the optimal level of vaginal fluid creatinine to detect rupture of membranes (ROM). Materials and methods: A total of 300 pregnant women were recruited for the study. Group I consisted of 100 women with a diagnosis of ruptured amniotic membranes confirmed by sterile speculum examination. Group II consisted of 100 women in whom a diagnosis of ROM was suspected but not confirmed by speculum examination. Group III consisted of 100 pregnant women without any complaints taken as a control group. In all 300 women, vaginal fluid washing for creatinine sample was taken. The parameters (age, parity, gestational age at the time of sample collection, amniotic fluid index (AFI), and vaginal fluid creatinine) were compared with one-way analysis of variance (ANOVA) and ScheVe multiple comparison test. Receiver operating characteristic (ROC) curve analysis was used to establish an optimal cut-off concentration. Results: The optimal cut-off value of vaginal fluid creatinine to detect ROM arrived based on ROC curve analysis was ≥0.3 mg/dL. The mean vaginal fluid creatinine in group I was 1.097 mg/dL, in group II was 0.3 mg/dL, in group III was 0.068 mg/dL. This study demonstrates that vaginal fluid creatinine could accurately diagnose a ROM with a sensitivity, specificity, positive predictive value, and negative predictive value of 98.36, 100, 100, and 97.14%, respectively.

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Vaginal fluid creatinine for the detection of premature rupture of membranes

Cited by 20 publications

References 7 publications

Use of vaginal creatinine levels in detecting premature rupture of membranes

Use of vaginal creatinine levels in detecting premature rupture of membranes

The value of measurement of vaginal fluid creatinine and beta-human chorionic gonadotropin in the diagnosis of premature rupture of membranes

Optimal Level of Vaginal Fluid Creatinine to Detect Rupture of Amniotic Membranes

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