QUANTITATIVE MEASUREMENT OF BETA SUBUNIT OF HUMAN CHORIONIC GONADOTRPHIN IN VAGINAL WASHING AND ITS ROLE IN DIAGNOSIS OF PREMATURE RUPTURE OF MEMBRANES

Background: Premature rupture of membranes (PROM) is defined as spontaneous rupture of the fetal membranes before the onset of labor. The exact pathophysiology of PROM is not well defined, but the currently accepted postulation is that of reduced fetal membrane strength. Diagnosis of PROM has instituted a clinical dilemma due to the lack of a diagnostic test with accepted accuracy. Vaginal washing ?-HCG may be helpful in diagnosis of PROM. Materials and methods: The current study assessed the role of quantitative measurement of ?-HCG in vaginal washing for diagnosis of PROM. Fifty pregnant females 28-40 weeks of gestation were recruited from Elshatby Maternity University Hospital, allocated into two groups; the first group included twenty five pregnant females complaining of evident passage of liquor before the onset of uterine contractions, while the other included twenty five pregnant females without passage of liquor. All cases were subjected to complete examination and laboratory assessment of vaginal washing ?-HCG. Results: ?-HCG ranged between 74.9 - 1338.0 mIU/L with mean value 394.2 ? 284.8 in PROM group, and 4.6 - 79.3 mIU/L with mean value 35.8 ? 23.8 in non PROM group, with a statistical significant difference. A cut-off value of 75.1 mIU/L has been recommended with a sensitivity of 96.5%, specificity of 92% and accuracy of 94%. Conclusion: Vaginal washing concentrations of ?-HCG significantly increases among patients with PROM, with cut-off value > 75.1 mIU/ml.