July 10th, 2020

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Diagnostic Value of Vaginal Prolactin in Premature Rupture of Membranes
Authors:  Mariam Lotfy, M.D., Rasha Elsayed, M.D., Noha Kamel, M.D., Noha Hammada, M.Sc., and Khaled Elnahas, M.D.
  OBJECTIVE: To assess the prognostic value of the vaginal washing fluid prolactin assay for premature rupture of membranes (PROM) diagnosis.

STUDY DESIGN: In a cross-sectional study, 80 pregnant women between 20 and 41 weeks’ gestation were included and subdivided into 2 subgroups (40 patients each) according to amniotic fluid pooling, nitrazine paper test results, and ferning. Group 1 was the PROM group. Group 2 was the intact membranes group without any complaint or complications. All patients underwent vaginal washing fluid sampling and prolactin level determination by ELISA technique. Receiver-operating characteristic curve was used to estimate the optimal cutoff value.

RESULTS: Mean values of vaginal washing fluid prolactin were statistically higher in the PROM group as compared to the intact membranes group (p<0.001), and a cutoff value of 8 μIU/mL had 100% sensitivity, 72.5% specificity, 78.4% positive predictive value, and 100% negative predictive value. Area under the curve was 95% with 95% confidence interval.

CONCLUSION: Determination of vaginal fluid prolactin could be used as a screening test for PROM but not as confirmatory test since it has a better negative predictive value than positive predictive value.
Keywords:  fetal membranes, PROM (pregnancy); premature rupture; prolactin; pregnancy; premature rupture of fetal membranes; premature rupture of membranes; prolactin; vaginal fluid
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