Practicability of using vaginal fluid markers in detecting premature rupture of membranes

2003 ◽  
Vol 40 (5) ◽  
pp. 542-545 ◽  
Author(s):  
Chen Yi Ni ◽  
Wang Xue Jia ◽  
Wu Min Yi ◽  
Lu Hai Feng ◽  
Lin Zhi Yu
Keyword(s):  
Sensitivity And Specificity ◽  
Roc Analysis ◽  
Random Access ◽  
Diagnostic Sensitivity ◽  
Vaginal Fluid ◽  
Emergency Setting ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Β Hcg ◽  
Diagnostic Sensitivity And Specificity

Background: Premature rupture of membranes (PROM) may cause intra-uterine infection and fetal death. A diagnostic tool that is non-invasive, specific and quick is needed to predict PROM. Human chorionic gonadotrophin (hCG), α-fetoprotein (AFP) and interleukin 6 (IL-6), which are present in vaginal fluid, were reported to be potential markers for PROM but have not yet been used in the clinic. This study was designed in a daily routine semi-emergency setting to evaluate the clinical practicability of using these markers in diagnosing PROM. Methods: Using a random-access automated luminescence immunoassay system, 81 vaginal washing samples collected from third trimester pregnant women (43 from PROM patients, 38 from patients with intact membranes) were analysed for β-hCG, AFP and IL-6 in a semi-emergency setting. The Mann-Whitney U-test was used to test the difference between the two groups. Receiver operator curve (ROC) analysis was used to evaluate the performance of the three markers and to determine the cut-off value for a positive diagnosis. Results: Vaginal fluid concentrations of the three markers were significantly different ( P < 0.001) between the two groups. ROC analysis indicated that AFP had a 97.7% diagnostic sensitivity and 100% specificity; the other two markers had lower diagnostic sensitivity and specificity (95.3% and 89.5% for β-hCG and 83.7% and 78.9% for IL-6, respectively). Discussion: This work demonstrates that, of the three markers investigated, AFP has the highest diagnostic sensitivity and specificity. Using the 'stat' function provided by the automated luminescence immunoassay system, the reporting time of the results was less than 1h. We conclude that vaginal fluid AFP measured by random-access automated luminescence immunoassay is an ideal marker for the diagnosis of PROM. The technique could be introduced into the laboratory as a semi-emergency service to meet clinical needs.

scholarly journals 215 Assessment of the Diagnostic Sensitivity and Specificity of Pain Biomarkers in Cattle Using Receiver Operating Characteristic Curves

2020 ◽  
Vol 98 (Supplement_3) ◽  
pp. 7-8
Author(s):  
Miriam S Martin ◽  
Michael Kleinhenz ◽  
Karen Schwartzkopf-Genswein ◽  
Johann Coetzee
Keyword(s):  
Diagnostic Accuracy ◽  
Receiver Operating Characteristic ◽  
Sensitivity And Specificity ◽  
Predictive Value ◽  
Roc Analysis ◽  
Operating Characteristic ◽  
Diagnostic Sensitivity ◽  
Diagnostic Sensitivity And Specificity ◽  
Good Diagnostic Accuracy ◽  
Receiver Operating

Abstract Biomarkers are commonly used to assess pain and analgesic drug efficacy in livestock. However, the diagnostic sensitivity and specificity of these biomarkers for different pain conditions over time have not been described. Receiver operating characteristic (ROC) curves are graphical plots that illustrate the diagnostic ability of a test as its discrimination threshold is varied. The objective of this analysis was to use area under the curve (AUC) values derived from ROC analysis to assess the predictive value of pain biomarkers at specific timepoints. The biomarkers included in the analysis were blood cortisol, salivary cortisol, hair cortisol, infrared thermography (IRT), mechanical nociceptive threshold (MNT), substance P, and outcomes from a pressure/force measurement system and visual analog scale. A total sample size of 7,992 biomarker outcomes were collected from 6 pain studies involving pain associated with castration, dehorning, lameness, and surgery were included in the analysis. Each study consisted of three treatments; pain, no pain, and analgesia. All statistics were performed using statistical software (JMP Pro 14.0, SAS Institute, Inc., Cary, NC). Results comparing analgesia verses pain yielded good diagnostic accuracy (AUC &gt; 0.7; 95% CI: 0.40 to 0.99) for blood cortisol (timepoints 1.5, 2, and 6 hours); IRT (timepoints 6, 8, 12, and 72 hours); and MNT (timepoints 6, 25, and 49 hours). These results indicate that ROC analysis can be a useful indicator of the predictive value of pain biomarkers and certain timepoints seem to yield good diagnostic accuracy while many do not.

scholarly journals The value of measurement of vaginal fluid creatinine and beta-human chorionic gonadotropin in the diagnosis of premature rupture of membranes

2021 ◽  
Author(s):  
Zafer Bütün
Keyword(s):  
Predictive Value ◽  
Accurate Method ◽  
Control Group ◽  
Lower Sensitivity ◽  
Vaginal Fluid ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Beta Human Chorionic Gonadotropin ◽  
Significant Difference ◽  
Β Hcg

Objective: The purpose of the present study is to evaluate β-human chorionic go- nadotropin (β-hCG) and creatinine levels in the vaginal fluid regarding to diagnosis of premature rupture of membranes (PROM). Material and Methods: This study was conducted on 150 pregnant women in the third trimester (28–40 weeks). The patients were grouped as: (1) PPROM group (75 cases) and (2) intact membranes as control group (75 cases). Three milliliters of ster- ile normal saline were inserted into the posterior fornix of the vagina and then vaginal fluid was aspirated. Creatinine and β-hCG levels in the vaginal fluid were measured β-hCG and creatinine levels were compared between the two groups. Results: The mean vaginal fluid level in Groups 1 and 2 was 0.60±0.72 (0.37) and 0.22±0.11 (0.2) for creatinine and β-hCG which was positive in 411.69±605.65 (146) and 12.71±24.63 (3.9), respectively. There was a statistically significant difference regarding to mean creatinine and β-hCG levels between two groups (p<0.001). Sen- sitivity, specificity, positive predictive value, negative predictive value, and accuracy were all 66.67%, 96%, 94.3%, 74.3%, and 81.3% for creatinine and 94.6%, 82.6%, 84.52%, 93.94%, and 88.67% for β-hCG in detecting PROM with a cutoff value of 0.21 mg/dl for creatinine and 16 mIU/ml for β-hCG. Conclusion: Measuring of β-hCG level in vaginal fluid is accurate, cheap, and simple methods in the diagnosis of PROM. Furthermore, measuring of creatinine level is a simple and accurate method with a lower sensitivity and accuracy than for β-hCG.

scholarly journals PREMATURE RUPTURE OF MEMBRANES

2018 ◽  
Vol 25 (02) ◽  
pp. 168-172
Author(s):  
Azmeena Azam ◽  
Hafiz Maoz Husnain ◽  
Iqra Marryum
Keyword(s):  
Cross Sectional Study ◽  
Chorionic Gonadotrophin ◽  
Human Chorionic Gonadotrophin ◽  
Vaginal Fluid ◽  
Effective Management ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Cross Sectional ◽  
Β Hcg ◽  
Hcg Test

Background: Pre-labour rupture of the membranes is one of the most commonclinical presentations in an obstetric setting. Early diagnosis is a major challenge faced byevery obstetrician and key to effective management and prevention of complications. As aresult of PROM, amniotic fluid that provides protection to the developing fetus is lost, exposingit to the outside environment. β-hCG is a hormone secreted by syncytiotrophoblasts found inamniotic fluid that can be studied for the evaluation of PROM. Objectives: To find the DiagnosticAccuracy of β human chorionic gonadotrophin test in vaginal washings taking amniotic fluidpooling as gold standard of diagnosing PROM. Study Design: Cross-sectional study. Setting:Unit II, Department of Obstetrics & Gynecology, Lahore General Hospital, Lahore. Period: Threemonths from January 2017 to March 2017. Material and methods: Females of age 18-40 yearswith gestational age >36weeks (calculated by LMP) complaining of PV leaking were includedin the study. Samples for β-hCG measurements were taken after informed consent. A β-hCGkit (Acu-check) was used for detection of β-hCG in vaginal fluid washings of pregnant women.Results: Diagnostic accuracy of β-hCG test was 91.66%. Sensitivity and specificity of β-hCGtest was 86.66% and 96.66%. Positive predictive and negative predictive value was 96.29% and87.87% respectively. Conclusion: Results of this study showed that for diagnosis of patientshaving PROM, beta human chorionic gonadotrophin (β-hCG) is a reliable, easy and quick test.

scholarly journals Clinical significance of small molecule metabolites in the blood of patients with different types of liver injury

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Hui Li ◽  
Yan Wang ◽  
Shizhao Ma ◽  
Chaoqun Zhang ◽  
Hua Liu ◽  
...  
Keyword(s):  
Oleic Acid ◽  
Clinical Diagnosis ◽  
Sensitivity And Specificity ◽  
Acid Amide ◽  
Hbv Infection ◽  
Diagnostic Sensitivity ◽  
Future Research ◽  
Diagnostic Efficacy ◽  
Metabolic Markers ◽  
Diagnostic Sensitivity And Specificity

AbstractTo understand the characteristic of changes of serum metabolites between healthy people and patients with hepatitis B virus (HBV) infection at different stages of disease, and to provide reference metabolomics information for clinical diagnosis of liver disease patients. 255 patients with different stages of HBV infection were selected. 3 mL blood was collected from each patient in the morning to detect differences in serum lysophosphatidylcholine, acetyl-l-carnitine, oleic acid amide, and glycocholic acid concentrations by UFLC-IT-TOF/MS. The diagnostic values of four metabolic substances were evaluated by receiver operating characteristic (ROC) curve. The results showed that the optimal cut-off value of oleic acid amide concentration of the liver cirrhosis and HCC groups was 23.6 mg/L, with a diagnostic sensitivity of 88.9% and specificity of 70.6%. The diagnostic efficacies of the three substances were similar in the hepatitis and HCC groups, with an optimal cut-off value of 2.04 mg/L, and a diagnostic sensitivity and specificity of 100% and 47.2%, respectively. The optimal cut-off value of lecithin of the HBV-carrier and HCC groups was 132.85 mg/L, with a diagnostic sensitivity and specificity of 88.9% and 66.7%, respectively. The optimal cut-off value of oleic acid amide of the healthy and HCC groups was 129.03 mg/L, with a diagnostic sensitivity and specificity of 88.4% and 83.3%, respectively. Lysophosphatidylcholine, acetyl-l-carnitine, and oleic acid amide were potential metabolic markers of HCC. Among them, lysophosphatidylcholine was low in the blood of HCC patients, and its diagnostic efficacy was better than that of acetyl-l-carnitine and oleic acid amide, providing reference metabolomics information in clinical diagnosis and future research.

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