الفهرس 
THE Fetal MembranesOnly 14 pages are availabe for public view
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Abstract
This Case – Control study was carried out at Ain Shams University Maternity Hospital. A total of 100 pregnant women between 28 -40 weeks of gestation were included in the study and classified into three groups:
Group I: It included 20 pregnant women between 28 -40 weeks of gestation ( Control group).
Group II: It included 40 pregnant women between 28 -40weeks of gestation (Suspected PROM group).
Group III: It included 40 pregnant women between 28-40 weeks of gestation ( Confirmed PROM group ).
At admission, all women underwent sterile Cusco speculum examination and amniotic fluid pooling with or without Valsalva maneuver was noted.
After giving an informed consent, 5ml of sterile saline solution was injected in the posterior vaginal fornix using a sterile Cusco speculum and 3ml of the injected saline was withdrawn with the same syringe and it was sent immediately to the laboratory for assay of prolactin hormone. This was followed by ultrasonic assessment of AFI for all women.
Then all patients were followed up until delivery and gestational age at delivery time was documented. The parameters (age, parity, gestational age at delivery, time interval between sampling and delivery, fetal weight, APGAR score after 1 minute and 5 minutes) were also documented.
The study was conducted to assess the reliability of vaginalwashing-fluid prolactin assay for the diagnosis of PROM and to determine a diagnostic cut-off value.
The current study showed that there is a high statistically significant difference between the three studied groups as regards gestational age at delivery and interval period .on the other hand there is no significant statistical difference could be detected between the studied groups as regards maternal age.
Also the current study showed that there is no statistically significant difference could be detected between the studied groups as regards parity.
As for assessment of fetal wellbeing, the study showed that control group had the best APGAR score either after 1 minute or 5 minutes with a statistically significant difference in between . Also the fetal weight was measured and comparatively it showed that control group had the best fetal weight compared to the other groups of rupture of membranes with a high statistically significant difference in between.
The current study also showed that there is a high statistically significant difference between the three studied groups as regards liquor volume where the group with definite rupture of membranes had significantly higher percentage of patients with below average liquor more than the other two groups.
Also this study showed that group with definite rupture of rupture of membranes had a high level of vaginal washing-fluid prolactin as compared to other groups with a high statistically difference in between.
The sensitivity, specificity, PPVand NPV of prolactin test in vaginal washing-fluid in diagnosis PROM were (90%, 85 % , 85.7% and 89.5%) as regarded diagnosis of PROM with cut-off value 0.09 ng/ml .
Despite the presence of false- positive and false – negative cases , this study reports an excellent sensitivity, specificity, PPVand NPV in detection of PROM .
from the present study, we can conclude that the use of the vaginal washing-fluid prolactin test for the diagnosis of PROM is simple, cheap, rapid , and reliable