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CC BY-NC-ND 4.0 · Rev Bras Ginecol Obstet 2017; 39(07): 317-321
DOI: 10.1055/s-0037-1603939
Original Article
Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil

Qualitative Determination of Human Chorionic Gonadotropin in Vaginal Washings for the Early Diagnosis of Premature Rupture of Fetal Membranes

Determinação qualitativa de gonadotrofina coriônica humana no lavado vaginal para o diagnóstico precoce de ruptura prematura de membranas fetais
Camila Buziquia Dartibale
1   Department of Medicine, Universidade Estadual de Maringá – UEM, Maringá, Paraná, PR, Brazil
,
Nelson Shozo Uchimura
1   Department of Medicine, Universidade Estadual de Maringá – UEM, Maringá, Paraná, PR, Brazil
,
Luiz Nery
1   Department of Medicine, Universidade Estadual de Maringá – UEM, Maringá, Paraná, PR, Brazil
,
Angelita Polato Schumeish
2   Laboratory Division, Hospital Universitário Regional de Maringá, Universidade Estadual de Maringá – UEM, Maringá, Paraná, PR, Brazil
,
Liza Yurie Teruya Uchimura
3   Departament of Preventive Medicine, Faculdade de Medicina, Universidade de São Paulo (DMP/FMUSP), São Paulo, São Paulo, SP, Brazil
,
Rosangela Getirana Santana
4   Departament of Statistics, Universidade Estadual de Maringá – UEM, Maringá, Paraná, PR, Brazil
,
Taqueco Teruya Uchimura
4   Departament of Statistics, Universidade Estadual de Maringá – UEM, Maringá, Paraná, PR, Brazil
› Author Affiliations
Further Information

Publication History

03 November 2016

04 April 2017

Publication Date:
16 June 2017 (online)

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Abstract

Purpose This study aimed to evaluate and validate the qualitative human chorionic gonadotropin β subunit (β-hCG) test of the vaginal fluid washings of pregnant women with premature rupture of fetal membranes (PROM).

Methods Cross-sectional study of pregnant women between gestational weeks 24 and 39 who underwent consultations in one of our institutions. They were divided into two groups: group A (pregnant women clinically diagnosed with PROM) and group B (pregnant women without loss of amniotic liquid). The patients were subjected to a vaginal fluid washing with 3 mL of saline solution, which was aspirated subsequently with the same syringe. The solution was immediately sent to the laboratory to perform the vaginal β-hCG test with cut-off points of 10 mIU/mL (β-hCG-10) and/or 25 mIU/mL (β-hCG-25).

Results The β-hCG-10 test of the vaginal secretion was performed in 128 cases. The chi-squared test with Yates' correction showed a statistically significant difference between the 2 groups (p = 0.0225). The sensibility, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy parameters were 77.1%, 43.6%, 52.3%; 70.4%; and 58.6% respectively. The β-hCG-25 test of the vaginal washing was performed in 49 cases. The analysis by Fisher's exact test showed a statistically significant difference between the groups (p = 0.0175). The sensibility, specificity, PPV, NPV, and accuracy parameters were 44.4%, 87.1%, 66.6%; 72.9%; and 71.4% respectively.

Conclusions The β-hCG-25 test showed better accuracy for the diagnosis of PROM, and can corroborate the early diagnosis of PROM because it is a simple and quick exam.

Resumo

Objetivo Este estudo objetivou validar o exame qualitativo da subunidade β da gonadotrofina coriônica humana (β-hCG) em lavado vaginal de gestantes com ruptura prematura de membranas (RPM) fetais.

Métodos Estudo transversal de gestantes com 24 a 39 semanas atendidas em um hospital de Maringá divididas em 2 grupos: grupo A (clinicamente diagnosticadas com RPM) e grupo B (gestantes sem perda de liquido amniótico). As pacientes foram submetidas a lavado vaginal com 3 mL de soro fisiológico, que logo em seguida foi aspirado de volta na mesma seringa e imediatamente enviado ao laboratório para a realização do exame de β-hCG vaginal com pontos de corte de 10 mIU/mL (β-hCG-10) e/ou 25 mIU/mL (β-hCG-25).

Resultados O teste de β-hCG-10 na secreção vaginal foi realizado em 128 casos, e o teste do qui-quadrado com correção de Yates mostrou diferença significante entre os dois grupos (p = 0,0225). Os parâmetros de sensibilidade, especificidade, valor preditivo positivo (VPP), valor preditivo negativo (VPN) e acurácia foram respectivamente 77,1%; 43,6%; 52,3%; 70,4%; e 58,6%. O teste de β-hCG-25 na secreção vaginal foi realizado em 49 casos, e a análise pelo teste exato de Fisher mostrou diferença significativa entre os grupos (p = 0,0175). Os parâmetros de sensibilidade, especificidade, VPP, VPN e acurácia foram respectivamente 44,4%; 87,1%; 66,6%; 72,9%; e 71,4%.

Conclusões O β-hCG-25 apresentou melhor acurácia para o diagnóstico de RPM, e pode corroborar o diagnóstico precoce de RPM por se tratar de um exame simples e rápido.

Keywords

human chorionic gonadotropin - β subunit - premature rupture of fetal membranes - diagnosis - obstetrics - pregnancy complications

Palavras-chave

gonadotrofina coriônica humana - subunidade β - ruptura prematura de membranas fetais - diagnóstico - obstetrícia - complicações na gravidez
 

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