Authors: El-Sokkary M.(MD), Anbar A. (MD), Wahba K. (MD), El-Mandouh M. (MD),  El-Shahawy Y (MD)


Abstract

To assess whether lactate determination in vaginal fluids ” Lac-test “, can be used as a diagnostic test for premature rupture of membranes (PROM) and to derive the best cutoff value for a positive test. It was a cross-sectional study performed at Al Azhar Bab El Sheria and Ain Shams Maternity Hospitals.  120 women were subdivided into 80 cases with sure or suspected history of PROM and 40 cases with no history of PROM as a control group for determination of lactate concentrations in vaginal fluid, nitrazine paper test and AFI were analysed. : A lactate concentration  ≥ 4.3 mmol/L was found to be the best cut-off value for a positive test. The “Lac-test” had a sensitivity of 89.06%, specificity 85.71%, positive and negative predictive values of 87.7% and 87.3%, respectively. Corresponding values for the nitrazine paper test were 75%, 75%, 77.4% and 72.4%. Likelihood ratio for a positive “Lac-test” was 6.2 and for a negative test 0.1. Corresponding values for the nitrazine paper test were 3 and 0.3 respectively. “Lac-test” is a valid test in cases with suspected PROM and may even be a better predictor than the nitrazine test.

Keywords

 Lactate Determination , Premature Rupture of Membranes

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Vaginal Fluid Lactate: A Method for the Diagnosis of Premature Rupture of Membrane