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Beta-HCG Concentration in Vaginal Fluid: Used as a Diagnostic Biochemical Marker for Preterm Premature Rupture of Membrane in Suspected Cases and Its Correlation with Onset of Labour

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Abstract

Objectives

To evaluate β-hCG concentration in vaginal fluid as a biochemical marker for PPROM in suspected cases and its correlation with onset of labour.

Materials and Methods

This is a prospective case–control study carried out in tertiary care centre in 1 year. Total 150 pregnant women of gestational age 28–36 week + 6 days were included and were divided into two groups: control (Group 1) (n = 50) normal antenatal patients. Group 2 cases with history of leaking per vaginum subdivided into two groups—Group 2A—(n = 50) with no detectable leakage of amniotic fluid present on per speculum examination and Group 2B—(n = 50) with minimal leaking per vaginum present upon per speculum examination (frank leaking were excluded). β-hCG level was measured by chemiluminescent microparticle assay, and all women were followed till onset of labour.

Results

Mean β-hCG level in vaginal fluid was measured as 6.10 ± 8.52 mIU/mL, 57.10 ± 30.86 mIU/mL and 111.35 ± 36.01 mIU/mL in Group 1, Group 2A and Group 2B, respectively. By taking 21.5 mIU/ml as cut-off, receiver operating characteristic curve shows sensitivity 100%, specificity 92.0%, positive predictive value 92.6%, negative predictive value 100% and diagnostic accuracy 96%. Regarding the correlation of β-hCG level with onset of labour if the β-hCG level is < 21.5 mIU/ml, 100% pregnancy continued beyond 4 weeks and 56% women delivered within 4 weeks when β-hCG level is > 75 mIU/ml.

Conclusion

β-hCG in vaginal fluid is a reliable biochemical marker for diagnosing suspected cases of PPROM and is well correlated with onset of labour.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, King George’s Medical University, Lucknow, India

    Soumya Jain, S. P. Jaiswar, Nisha Singh, Sujata Deo & Monica Agarwal

  2. Department of Pathology, Department of Obstetrics and Gynecology, King George’s Medical University, Lucknow, India

    Wahid Ali

Authors
  1. Soumya Jain
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  2. S. P. Jaiswar
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  3. Nisha Singh
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  4. Sujata Deo
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  5. Monica Agarwal
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  6. Wahid Ali
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Corresponding author

Correspondence to S. P. Jaiswar.

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Conflict of interest

There are no conflicts of interest in the study.

Research Involving Human Participants and/or Animals

Yes and an informed consent were taken from the patients.

Ethical Statement

A prior approval was obtained from the King George’s Medical University (K.G.M.U.) of Lucknow, India ethics committee vide letter no-794/Ethics/18 to conduct this research.

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Dr. S. P. Jaiswar is an Professor & Unit Head, Dept. of Obs & Gynae, KGMU; Dr. Soumya Jain is an MD, Dept. of Obs & Gynae, KGMU; Dr. Nisha Singh is an Professor, Dept. of Obs & Gynae, KGMU; Dr. Sujata Deo is an Professor, Dept. of Obs & Gynae, KGMU; Dr. Monica Agarwal is an Assistant Professor, Dept. of Obs & Gynae, KGMU; Dr. Wahid Ali is an Associate Professor, Dept. of Pathology, KGMU.

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Jain, S., Jaiswar, S.P., Singh, N. et al. Beta-HCG Concentration in Vaginal Fluid: Used as a Diagnostic Biochemical Marker for Preterm Premature Rupture of Membrane in Suspected Cases and Its Correlation with Onset of Labour. J Obstet Gynecol India 70, 283–288 (2020). https://doi.org/10.1007/s13224-020-01327-3

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  • DOI: https://doi.org/10.1007/s13224-020-01327-3

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