DIAGNOSTIC ACCURACY OF VAGINAL FLUID Β-HCG FOR PRELABOUR RUPTURE OF MEMBRANES IN A NIGERIAN TERTIARY HOSPITAL

ABSTRACT Premature rupture of membranes (PROM) remains a leading cause of preterm births and adverse perinatal outcomes, particularly in sub-Saharan Africa where diagnostic limitations persist. This study assessed the diagnostic value of vaginal fluid creatinine for identifying PROM among pregnant women in a tertiary care centre. A total of 200 participants were recruited and classified into three groups: confirmed PROM (n=50), suspected PROM (n=50), and controls without PROM (n=100). Sterile saline was introduced into the vaginal fornix and re-aspirated for analysis. Vaginal fluid samples were centrifuged, and creatinine levels were measured spectrophotometrically. Mean creatinine levels were highest in the confirmed group (1.2762 ± 0.42 mg/dL), followed by the suspected (0.5578 ± 0.38) and control groups (0.0963 ± 0.65), (p < 0.001). Receiver operating characteristic (ROC) analysis yielded an optimal cut-off of 0.715 mg/dL, with a sensitivity of 98.0%, specificity of 90.0%, and an area under the curve of 0.967. A clear inverse relationship was observed between creatinine levels and amniotic fluid index. Vaginal fluid creatinine is thus a highly accurate, rapid, and cost-effective tool for confirming PROM, offering particular value in low-resource settings.These findings suggest that vaginal fluid creatinine is a highly accurate, rapid, and cost-effective diagnostic tool for PROM, with potential to reduce diagnostic uncertainty and improve maternal-fetal outcomes in low-resource obstetric settings.