جستجوی مقالات مرتبط با کلیدواژه « ترشحات سرویکوواژینال » در نشریات گروه « پزشکی »

Abstract 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. 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. 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. 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

With respect to the prevalence and complications of premature rupture of chorionic membranes (PROM) and the importance of correct and on-time detection of the disorder with false positive or negative results, accurate as well as noninvasive diagnostic procedures are always needed.This case-control study was conducted to identify the diagnostic power of qualitative evaluation of beta human chorionic gonadotropins (ßHCG) in cervicovaginal discharge with 1-step test strips (25 IU/ml) for detecting PROM in women referring to Vali-e-Asr Hospital at Zanjan city in 2007. 86 singletons between 14 and 41 weeks of gestation were selected. Data collection tools included a form for demographic information as well as gestational history and an observation checklist for speculum examination and tests of Fern, nitrazine and qualitative strip for ßHCG. Of women with amniotic fluid leakage, subjects were examined in 2 43-person groups including those with definite PROM (direct observation with speculum [+], Fern test [+] and nitrazine test [+]) in case group and those with intact membranes (direct observation with speculum [-], Fern test [-] and nitrazine test [-]) in control group. Subjects were matched in terms of gestational weeks in the two groups. Cervicovaginal discharge samples were taken by rinsing posterior fornix with 5ml saline and aspiration of fluid. ßHCGs were then tested by 1-step gestational strips. It was found that sensitivity, specificity, positive as well as negative predictive values and accuracy of the strips were 97.7%, 88.4%, 89.4%, 97.5% and 93%. It seems that the diagnostic power of qualitative evaluation of ßHCGs in cervicovaginal discharge to detect PROM is acceptable.

Premature rupture of membranes (PROM) is defined as rupture of membranes before the onset of labor at any time during the gestational period, which occurs in 2-25% of pregnancies. Based on complications related to PROM, such as preterm labor and increased perinatal mortalities, the importance of correct and on-time diagnosis of PROM and high false positive and negative results of diagnostic tests, this research was conducted to compare the diagnostic power of qualitative and quantitative measurements of ß-hCG in cervicovaginal washing-fluid for the diagnosis of PROM in pregnant women attending Vali-e-Asr Hospital in Zanjan, Iran during 2006. This case-control research process design was done on cervicovaginal samples collected from 86 singleton pregnancies between 14-41 weeks of gestational age. Data were collected through a questionnaire, which included demographic data, pregnancy histories and a checklist for entering the result of speculum examination, fern and nitrazine tests, ELISA and qualitative strip tests for ß-hCG. Subjects with a chief complaint of amniotic fluid leakage, who had been matched for gestational age, were divided into two 43-member groups: 1- Confirmed PROM by speculum examination, with positives result of amniotic fluid pooling, nitrazine paper test and fern test and 2- The control group undergoing speculum examination with negative results of amniotic fluid pooling, nitrazine paper test and fern test. Cervico-vaginal fluids were collected from the posterior vaginal fornix by 5ml of sterile saline irrigation and aspiration technique. Subsequently, β-hCG was checked by quantitative ELISA and one-step qualitative pregnancy test. The mean β-hCG levels were 250.60±118.6mIU/ml and 6.2±10.6mIU/ml in PROM and the control groups respectively. Calculations of receiving operating characteristic curve showed that the cut-off point for ELISA was 22.32mIU/ml and its sensitivity, specificity, positive and negative predictive values and accuracy were 95.3%, 97.7%, 97.6%, 95.5% and 96%, respectively. The one-step qualitative pregnancy test was positive in 42 PROM subjects, (97.7%), and in 5 of the control group, therefore, its sensitivity, speci-ficity, positive and negative predictive values and accuracy were 97.7%, 88.4%, 89.4%, 97.5% and 93%, respectively. It seems that a very good agreement exists between the results of the two methods based on a Kappa coefficient value of 0.86. It seems that qualitative and quantitative measurements of cervicovaginal washing-fluid -hCG are accurate, fast and simple for the diagnosis of PROM, especially in suspicious cases.

Premature rupture of membranes (PROM), occurs in 2-25% of pregnant women. Traditionally, clinical and laboratory tests utilized for the diagnosis of PROM are fraught with both false positive and false negative results caused by various factors that result in an equivocal or delayed diagnosis. The absence of a non-invasive 'gold standard' for the diagnosis of PROM has led to the search for alternative biochemical markers. This research has been conducted to compare the diagnostic power of qualitative and quantitative HCG of cervicovaginal washings for the diagnosis of PROM.s

This Diagnostic-Experimental study was undertaken with cervico-vaginal samples collected from singleton pregnancies between 14-41 weeks of gestation. Totally 86 pregnant women referred to Vali-Asr Hospital, Zanjan, in 2006, were enrolled in this study. Subjects were divided in two groups: 43 subjects with confirmed PROM (amniotic fluid pooling (+), nitrazine paper test (+), and fern test (+)), and 43 women in the control group (amniotic fluid pooling (-), nitrazine paper test (–), and fern test (-)). Washings were then collected from the posterior vaginal fornix with the use of 5 ml of sterile saline irrigation and aspiration techniques. We measured HCG levels with the ELISA test.

The median HCG levels were 250.60 (mIU/mL) and 6.2 (mIU/mL) in PROM and control group respectively. With, 22 (mIU/mL) set as a cutoff value on the receiving operating characteristic curve, (ROC), sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 95.3, 97.7, 97.6, 95.5 and 96%, respectively.

Quantitative HCG measurement of cervico-vaginal washings was an accurate test for the diagnosis of PROM in our study.