بررسی قدرت اوره و کراتینین ترشحات سرویکوواژینال در تشخیص پارگی پیش از موعد پرده های جنینی

Abstract Background: Regarding to prevalence and complications of no- or mis- diagnosis of premature rupture of membrane (PROM), and also high rate of false positive and negative results of traditional diagnostic methods, this study was designed to evaluate diagnostic values of urea and creatinin values of cervicovaginal discharges in determining of PROM in pregnant women referred to Khatam-ol-Anbia hospital, Gonbad, Iran in 2008. Methods: In a clinical trial- diagnostic study, 84 pregnant women with gestational age of 20-41 weeks and chief complaint of watery vaginal discharge were studied. They divided in two groups of PROM (n=42) and intact membrane (n=42) matched by gestational age. Secretions of posterior phornix of vagina were collected by 5 milliliter normal saline. Urea value was measured by enzymatic photometry or urease, and creatinin value was determined by Jaffee synthetic chemical colorimetry. Data were analyzed by descriptive and analytic statistics. Results: Urea value of cervicovaginal secretions in PROM and control groups was 14.7±4.27 and 2.9±1.5 mg/dL, respectively. Regarding to cut-off of 7 mg/dl, sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of urea of cervicovaginal discharge was 100 percent in diagnosis of PROM. Creatinin value of cervicovaginal secretions in PROM and control groups was 1.4±0.4 and 0.2±0.1 mg/dL, respectively. Regarding to cut-off of 0.55 mg/dl, sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of creatinin of cervicovaginal discharge was 100 percent in diagnosis of PROM. Conclusion: It seems that measuring urea and creatinin of cervicovagal discharge can be used as a simple, new, rapid and reliable method to diagnose premature rupture of membrane in pregnant women. KEYWORDS: premature rupture of membrane, Urea, Creatinin, Cervicovaginal discharge.