الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Summary and Conclusion
remature rupture of membranes (PROM) means rupture of
both envelopes prior to labour at any time during the
gestational period. It is an obstetric problem that complicates
approximately 10% of all pregnancies. It is associated with
infectious morbidity in mother and fetus (chorioamnionitis), cord
accidents, or preterm labour. For these reasons, its correct
diagnosis is very important, on the other hand, over diagnosis
leads to unnecessary interventions like hospitalization or induction
of labor.
This study showed that confirmed PROM group had
higher levels of vaginal fluid urea and creatinine compared to
suspected PROM group and control group with a very highly
statistically significant difference between the groups.
It was observed that vaginal fluid urea levels ≥ 13 mg/dl
are highly predictive of membranes rupture with 100%
diagnostic sensitivity, 84.37% diagnostic specificity, 76.2 %
PPV and 80.6 % NPV. The performance of this marker in
diagnosing PROM was therefore very good. Also, it was
observed that vaginal fluid creatinine levels ≥ 0.9 mg/dl are
highly predictive of membranes rupture with 100 % diagnostic
sensitivity, 85.94 % diagnostic specificity, 78 % PPV and 100
% NPV. The performance of this marker in diagnosing PROM
was also very good.
P
Summary and Conclusion
7 0
In the present study, there were no statistically significant
correlation between vaginal fluid urea and creatinine levels
versus maternal age, parity and gestational age. It was observed
that there were very highly statistically significant positive
correlations between vaginal fluid urea and creatinine versus
amniotic pooling by Cusco speculum examination. Also, there
were very highly statistically significant inverse correlations
between vaginal fluid urea and creatinine levels versus amniotic
fluid index (AFI) at time of obtaining the sample, this means
that when AFI at time of obtaining the sample the sample
decrease, vaginal fluid urea and creatinine levels will increase
and vice versa is true.
This study concluded that vaginal fluid urea and
creatinine determination for the diagnosis of PROM is a rapid,
simple and non-invasive method and had higher sensitivity and
specificity to establish accurate diagnosis. It is a possible
candidate to become a gold standard diagnostic test for PROM