Diagnosis of Premature Rupture of Membranes by Assessment of Urea and Creatinine in Vaginal Washing Fluid

Document Type : Original Article

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1 obstetrics and gynecology, faculty of medicin, zagazig univeristy , zagazig, egypt

2 Department of Obstetrics and Gynecology, Faculty of Medicine –Zagazig University, Zagazig, Egypt

Abstract

Premature rupture of membranes (PROM) refers to fetal membranes’ rupture before the onset of labor. Any patient with a history of vaginal leakage during pregnancy or a decreased level of amniotic fluid in ultrasound should be evaluated carefully because of the adverse effects on pregnancy outcomes. Detecting PROM is sometimes easy in a speculum examination with the observation of amniotic fluid accumulation in the vagina or liquid outflow from cervix. There are a few methods for PPROM diagnosis. Fern and nitrazine are two traditional, commonly used tests. Ultrasound examination with amniotic fluid determination is not a good test because it cannot differentiate PROM from other causes of oligohydramnios. The Amnisure ROM test is another new test that is easy, fast, and minimally invasive, with high sensitivity and specificity. Several markers have been studied such as alpha-fetoprotein, fetal fibronectin, creatinine, insulin growth factor binding protein 1, urea, prolactin, and β-hCG. Urea and creatinine are both excreted through glomerular filtration. These markers are also available in amniotic fluid and have been examined for finding PPROM.

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