Vaginal Fluid Urea and Creatinine as Biomarkers of Prelabor Rupture of Membranes (PROM)

Objective: The aim of the current study was to evaluate the diagnostic value of vaginal fluid urea and creatinine in women with PROM. Study Design: Diagnostic test accuracy study. Setting: Ain Shams University Maternity Hospital, Cairo, Egypt. Methods: The study included three groups of women: Group I including women with confirmed prelabor rupture of the membranes (PROM); group II including women with suspected PROM; and group III including women with intact membranes. All included women underwent sterile speculum vaginal examination. The vaginal posterior fornix was irrigated; the retrieved fluid was sent for urea and creatinine assays. Results: A total of 96 women were included in the study, divided into 3 groups: Group I (n=32), including women with confirmed PROM; group II (n=32), including women with suspected PROM; and group III (n=32), including women with intact membranes as a control group. The vaginal fluid urea and creatinine concentrations were significantly higher in women with confirmed PROM when compared to women with suspected PROM and women of the control group. Both markers were significant discriminators of confirmed PROM from suspected or no PROM, as denoted by the significantly large area under the curves. Conclusion: Vaginal fluid urea and creatinine concentrations are significant markers for confirmation of diagnosis of PROM.