Skip to main content Skip to main navigation menu Skip to site footer

The beta Human Chorionic Gonadotropin (hCG) levels in the vaginal washing fluid as a predictor of Premature Rupture of Membrane (PROM)

  • Danny Aguswahyudi ,
  • Ketut Suwiyoga ,
  • I Ketut Surya Negara ,
  • I Wayan Megadhana ,
  • I Nyoman Bayu Mahendra ,
  • I Gusti Putu Mayun Mayura ,
  • Made Bagus Dwi Aryana ,

Abstract

Background: Several biomarkers have been investigated as predictors of Premature rupture of membrane (PROM), but these biomarkers have not been applied in clinical practice due to their high cost and complexity. Beta-HCG is thought to be an easy, cost-effective and promising predictor of PROM in clinical practice. This study aims to determine the relationship between beta-hCG level in vaginal washing fluid with the PROM and the cut-off value of beta-hCG level in vaginal washing fluid in predicting the incidence of PROM.

Methods: This diagnostic study was conducted in the Sanglah General Hospital, Denpasar, from May to July 2020. The subjects involved in this study are all pregnant women with gestational age ?24 weeks who came with complaints of vaginal discharge and were treated in the delivery room of the Emergency Ward, Sanglah General Hospital. The beta-HCG level was evaluated using the immunoassay method and the ROC curve analysis was performed to determine the beta-hCG level in vaginal washing cut-off point that can predict the incidence of PROM. Data were analyzed using SPSS version 22 for Windows.

Results: Thirty-five subjects who met the inclusion and exclusion criteria were involved in this study. The cut-off value of beta-hCG vaginal washing fluid to predict PROM obtained in this study was 118.1 mIU/ml with sensitivity of 95.83%, specificity of 81.81%, PPV of 92.00%, NPV of 90.00%, and accuracy of 91.43% (AUC: 0.947; 95%CI: 0.870-1.000; p<0.001).

Conclusion: Beta-hCG level in the vagina washing fluid can be used as a fast and non-invasive predictor of PROM in pregnant women.

References

1. Skupski D. Preterm premature rupture of membranes (PPROM). J Perinat Med. 2019;47(5):491-492.
2. Lee T, Silver H. Etiology and epidemiology of preterm premature rupture of the membranes. Clin Perinatol. 2001;28(4):721-734. doi:10.1016/s0095-5108(03)00073-3
3. Temel O, Cö?endez E, Selçuk S, Aso?lu MR, Kaya E. ?-human chorionic gonadotropin assay in vaginal washing fluid for the accurate diagnosis of premature rupture of membranes during late pregnancy. J Turk Ger Gynecol Assoc. 2013;14(4):201-204.
4. Dartibale CB, Uchimura NS, Nery L, Schumeish AP, Uchimura LYT, Santana RG, et al. Qualitative Determination of Human Chorionic Gonadotropin in Vaginal Washings for the Early Diagnosis of Premature Rupture of Fetal Membranes. Rev Bras Ginecol Obstet. 2017;39(7):317-321.
5. Bouvier D, Forest JC, Blanchon L, Bujold E, Pereira B, Bernard N, Gallot D, Sapin V, Giguère Y. Risk Factors and Outcomes of Preterm Premature Rupture of Membranes in a Cohort of 6968 Pregnant Women Prospectively Recruited. J Clin Med. 2019;8(11):1987.
6. Kletzky OA, Rossman F, Bertolli SI, Platt LD, Mishell DR Jr. Dynamics of human chorionic gonadotropin, prolactin, and growth hormone in serum and amniotic fluid throughout normal human pregnancy. Am J Obstet Gynecol. 1985;151(7):878-884.
7. Kariman N, Afrakhte M, Hedayati M, Fallahian M, Alavi Majd H. Diagnosis of premature rupture of membranes by assessment of urea and creatinine in vaginal washing fluid. Iran J Reprod Med. 2013;11(2):93-100.
8. Assefa NE, Berhe H, Girma F, Berhe K, Berhe YZ, Gebreheat G, et al. Risk factors of premature rupture of membranes in public hospitals at Mekele city, Tigray, a case control study. BMC Pregnancy Childbirth. 2018;18(1):386.
9. Esim E, Turan C, Unal O, Dansuk R, Cengizglu B. Diagnosis of premature rupture of membranes by identification of beta-HCG in vaginal washing fluid. Eur J Obstet Gynecol Reprod Biol. 2003;107(1):37-40.
10. Jain A, Paul M. A study of maternal outcome in term premature rupture of membranes in a tertiary care hospital. International Journal of Reproduction, Contraception, Obstetrics and Gynecology (IJRCOG). 2020;9(7):2953-2958.
11. Kim YH, Park YW, Kwon HS, Kwon JY, Kim BJ. Vaginal fluid beta-human chorionic gonadotropin level in the diagnosis of premature rupture of membranes. Acta Obstet Gynecol Scand. 2005;84(8):802-805.
12. Osman OM, Elghazaly M. Can Vaginal Washing Flued Urea, Creatinine, and Qualitative beta hCG Diagnose Suspected Premature Rupture of Membranes. Open Journal of Obstetrics and Gynecology. 2014; 4(15): 967-972.
13. Ochs J. Pregnant Women Experiencing Job-Related Fatigue Face Elevated Risk of Premature Membrane Rupture. International Family Planning Perspectives. 2001;27(3):160.
14. Lovereen S, Khanum MA, Nargis N, Begum S, Afroze R. Maternal and Neonatal outcome in premature rupture of membranes. Bangladesh Journal of Medical Sciences. 2018; 17(3):479-483.
15. Underwood MA, Gilbert WM, Sherman MP. Amniotic fluid: not just fetal urine anymore. J Perinatol. 2005;25(5):341-348.
16. Cole LA. Biological functions of hCG and hCG-related molecules. Reprod Biol Endocrinol. 2010;8:102.
17. Adnyana IBP, Liwang F, Negara KS, Manuaba IBP, Bhargah A, Prabawa IPY. Clinical risk factor of preeclampsia: a five-year retrospective study in Bali Royal Hospital, Bali- Indonesia. Gineco.eu. 2018;14(53):89–93.

How to Cite

Aguswahyudi, D., Suwiyoga, K., Negara, I. K. S., Megadhana, I. W., Mahendra, I. N. B., Mayura, I. G. P. M., & Aryana, M. B. D. (2022). The beta Human Chorionic Gonadotropin (hCG) levels in the vaginal washing fluid as a predictor of Premature Rupture of Membrane (PROM). Intisari Sains Medis, 13(1), 75–78. https://doi.org/10.15562/ism.v13i1.1216

HTML
72

Total
81

Share

Search Panel

Danny Aguswahyudi
Google Scholar
Pubmed
ISM Journal


Ketut Suwiyoga
Google Scholar
Pubmed
ISM Journal


I Ketut Surya Negara
Google Scholar
Pubmed
ISM Journal


I Wayan Megadhana
Google Scholar
Pubmed
ISM Journal


I Nyoman Bayu Mahendra
Google Scholar
Pubmed
ISM Journal


I Gusti Putu Mayun Mayura
Google Scholar
Pubmed
ISM Journal


Made Bagus Dwi Aryana
Google Scholar
Pubmed
ISM Journal