July-August 2015 · Volume 4 · Issue 4 Page 1070 International Journal of Reproduction, Contraception, Obstetrics and Gynecology Tigga MP et al. Int J Reprod Contracept Obstet Gynecol. 2015 Aug;4(4):1070-1075 www.ijrcog.org pISSN 2320-1770 | eISSN 2320-1789 Research Article Comparative analysis of four biomarkers in diagnosing premature rupture of membranes and their correlation with onset of labour Maureen Prativa Tigga*, Sunita Malik INTRODUCTION Premature rupture of membranes (PROM) is the rupture of fetal membranes before the onset of labour. PROM affects 3 to 18.5% of all pregnancies and there is no demonstrable cause in most of these cases. 1 PROM has been a conundrum for the obstetricians and its correct diagnosis is important for implementing gestational age-specific obstetric interventions. PROM is easy to diagnose when the rupture is overt but difficult when the rupture is slight. A timely diagnosis ensures proper intervention thereby improving the maternal and fetal outcomes. On the contrary, a false-positive diagnosis of preterm PROM may lead to unnecessary hospitalization, antibiotics and corticosteroids administration, and induction of labour. The diagnosis of PROM has conventionally relied on patient’s history of fluid leakage per vaginum, confirmed by the presence of pooling of amniotic fluid in vagina on speculum examination. The alkaline vaginal pH detected by nitrazine paper and the presence of ferning pattern after microscopic examination of dried vaginal secretions also aid in diagnosis. However there are drawbacks of these conventional methods. In case of long latent period, amniotic pooling cannot be demonstrated on speculum examination but this does not exclude membrane rupture. Friedman and Mc Elin showed poor reliability of Department of Obstetrics & Gynaecology, Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi, India Received: 25 May 2015 Accepted: 06 June 2015 *Correspondence: Dr. Maureen Prativa Tigga, E-mail: maureentigga@gmail.com Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. ABSTRACT Background: The diagnosis of equivocal cases of premature rupture of membranes (PROM) with traditional methods has been unreliable therefore various biochemical markers have been sought to confirm the same. This study aims to determine the most reliable marker amongst β human chorionic gonadotropin (βhCG) ά fetoprotein (AFP), prolactin and creatinine in vaginal washing for diagnosing PROM and to establish the correlation between the level of these markers and the onset of labour. Methods: Fifty pregnant women between 20 and 40 weeks of gestation with history of leaking per vaginum (study group) and an equal number of gestation matched pregnant women without leak (control group) were recruited to the study. All women underwent speculum examination aiming to sample and assay the two markers. The duration from PROM to onset of labour was recorded in the study group. Data was analyzed by student’s t -test, receiver operator curve and chi square test. Results: Vaginal washing concentration of the markers were significantly higher in the study group (p<0.01) thereby rendering them as markers for diagnosing PROM. There was negative correlation coefficient between the levels of markers and duration from PROM to onset labour, denoting early onset of labour in patients with higher levels of markers. Conclusions: AFP and creatinine were better markers for diagnosing premature rupture of membranes while β human chorionic gonadotropin was the better predictor of onset of labour. Keywords: Premature rupture of membranes, β human chorionic gonadotropin, ά fetoprotein, Prolactin, Creatinine DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20150429