Prof. Zohra Khanum Department of Obstetrics and Gynaecology, Fatima Jinnah Medical College, Lahore
E-mail: zohradr@yahoo.com

ABSTRACT

Objectives: To determine diagnostic accuracy of qualitative test of hCG in vaginal washing fluid for the diagnosis of rupture of membranes in uncertain cases taking vaginal fluid urea estimation as gold standard test.
Study Design: It was a Cross-sectional study, conducted in department of Obstetrics and Gynecology, Lady Aitchison Hospital and Sir Ganga Ram hospital Lahore. This study was carried out over a period of six months from 30- 04-2014 to 31-10-2014.
Methodology: A total of 200 patients were included in the study with the history of ruptured membranes. For 10 seconds, qualitative HCG test strip with sensitivity 25 IU/mL was inserted in vaginal washing fluid. hCG qualitative test was interpreted after 5 minutes as positive with appearance of two red coloured lines, negative if one line appeared and invalid if no line appeared and invalid test was repeated with another strip.
Result: Mean age of the patients was 24.95±4.33 years. In this study 76 patients (38.0%) were primigravida and 124 patients (62.0%) were multigravida. Comparison of human chorionic gonadotropin versus vaginal fluid urea revealed 168 positive and 32 negative cases on HCG while 188 positive and 12 negative cases on vaginal fluid urea (gold standard). Sensitivity was 88.8%, specificity 91.6%, diagnostic accuracy 89.0%, positive predictive value 99.4% and negative predictive value of human chorionic gonadotropin was 34.3%.
Conclusion: The qualitative determination of hCG in vaginal washings proved a rapid, simple, reliable, and noninvasive test in the diagnosis of premature rupture of membranes. 
Key Words: PROM, Human chorionic gonadotropin, Vaginal washing fluid, Vaginal fluid urea level.

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