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    MENTOR: Dr. Masjuanda, SP - OG

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    bella karina
    A study examined the predictive value of routine urine tests in cases of premature rupture of membranes (PROM). Urine samples were collected from 100 women with preterm PROM, 100 women with full-term PROM, 100 pregnant women with normal delivery, and 100 non-pregnant healthy women. The study found bacteria counts were significantly lower in the preterm PROM group compared to the other pregnant groups. Bacteria had the largest area under the ROC curve, indicating it has some predictive value. When using a bacteria cutoff of 130.15, the sensitivity was 58% and specificity was 79%. The study concludes that routine urine tests, especially bacterial counts, have partial predictive value for PROM diagnosis and management.

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    MENTOR: Dr. Masjuanda, SP - OG

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    bella karina
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    A study examined the predictive value of routine urine tests in cases of premature rupture of membranes (PROM). Urine samples were collected from 100 women with preterm PROM, 100 women with full-term PROM, 100 pregnant women with normal delivery, and 100 non-pregnant healthy women. The study found bacteria counts were significantly lower in the preterm PROM group compared to the other pregnant groups. Bacteria had the largest area under the ROC curve, indicating it has some predictive value. When using a bacteria cutoff of 130.15, the sensitivity was 58% and specificity was 79%. The study concludes that routine urine tests, especially bacterial counts, have partial predictive value for PROM diagnosis and management.

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    A study examined the predictive value of routine urine tests in cases of premature rupture of membranes (PROM). Urine samples were collected from 100 women with preterm PROM, 100 women with full-term PROM, 100 pregnant women with normal delivery, and 100 non-pregnant healthy women. The study found bacteria counts were significantly lower in the preterm PROM group compared to the other pregnant groups. Bacteria had the largest area under the ROC curve, indicating it has some predictive value. When using a bacteria cutoff of 130.15, the sensitivity was 58% and specificity was 79%. The study concludes that routine urine tests, especially bacterial counts, have partial predictive value for PROM diagnosis and management.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    9 views20 pages

    MENTOR: Dr. Masjuanda, SP - OG

    Uploaded by

    bella karina
    A study examined the predictive value of routine urine tests in cases of premature rupture of membranes (PROM). Urine samples were collected from 100 women with preterm PROM, 100 women with full-term PROM, 100 pregnant women with normal delivery, and 100 non-pregnant healthy women. The study found bacteria counts were significantly lower in the preterm PROM group compared to the other pregnant groups. Bacteria had the largest area under the ROC curve, indicating it has some predictive value. When using a bacteria cutoff of 130.15, the sensitivity was 58% and specificity was 79%. The study concludes that routine urine tests, especially bacterial counts, have partial predictive value for PROM diagnosis and management.

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    of 20

    A Routine Urine Test has Partial Predictive

    Value in Premature Rupture Of the


    Membranes

    MENTOR : dr. Masjuanda, Sp.OG

    ARIE FRANATA 18360028


    ASTRIDA AGUSTINA 18360029
    BACHTIAR MUCHHAJ 18360033
    BELLA KARINA 18360037

    DEPARTMENT OF OBSTETRICS AND GYNECOLOGY


    UNIVERSITY OF MALAHAYATI
    DELI SERDANG HOSPITAL
    2019
    BACKGROUND

    The prevalence of premature rupture


    of the membranes (PROM) in China
    is 2.7% to 17%. Preterm premature
    rupture of the membranes (PPROM)
    at <37 weeks of gestation is the most
    harmful, with an incidence of 2.0% to
    3.5%. A total of 30% to 40% of
    preterm births are related to PPROM,
    and preterm birth is associated with
    75% of perinatal deaths.
    The pathogenesis of PPROM is unclear, but it
    usually results from interaction of many factors.

    Reproductive tract infection is a major concern


    of researchers. More than 60% of PPROM is
    related to infection and subsequent cascade
    amplification of the inflammatory response.
    LITERATURES SOURCES

    Literatures of this journal were


    carried out through the
    International Medical Research
    Journal, accessible at the
    National Center for
    Biotechnology Information
    (NCBI) web.

    Keywords: premature rupture of the membranes,


    routine urine test, predictive value, preterm, and
    fullterm.
    Materials and Methods
    Patients
    We included pregnant women who were admitted to the Maternity Department of Qilu Hospital of
    Shandong University from February 2017 to October 2018.

    CRITERIA:

    INCLUSION EXCLUSION

    (a) no urinary tract (a) patients who did not All participants used
    infection; meet the inclusion disposable sterile urine
    criteria; and cups to collect
    (b) singleton specimens and prevent
    pregnancy; and (b) the specimen
    cross-infection.
    collection time did
    (c) no antibacterials not meet the
    were used in the past prescribed time
    2 weeks. limit.
    A total of 100 patients with PROM with a gestational
    age >37 weeks were selected and a routine urine
    routine examination was conducted 7 days before
    rupture of the membranes.

    Additionally, 100 women with full-term gestational age


    >37 weeks and <42 weeks (full-term group) were
    randomly selected and urine routine specimens were
    collected within 24 hours before delivery.

    A total of 100 patients with PPROM whose gestation was


    <37 weeks were selected and they received routine urine
    tests within 7 days before rupture of the fetal membranes.

    Finally, 100 nonpregnant adult healthy women


    (normal group) were randomly selected and clean
    midstream urine specimens were collected.
    URINE ANALYSIS METHOD

    Measurements included leukocytes, occult blood, protein, glucose, ketone


    bodies (KET), urobilinogen, urobilirubin, pH values, urine specific gravity
    (SG), and nitrite.
    Arkray AX-4030 (Arkray Corp., Kyoto, Japan).

    The Components mainly included WBC count, red blood cell (RBC) count, epithelial
    cell count (EC), cast, pathological cast, bacteria, small round cells, yeast, crystals, and
    electrical conductivity.
    Sysmex UF1000i (Sysmex Corp., Kobe, Japan).

    In specimens that could not be correctly detected by an


    instrument, the numbers of WBCs, RBCs, ECs, cast, and
    crystals were confirmed by a microscopic examination.
    DATA ANALYSIS
    First, the Kolmogorov– The Levene method
    Smirnov test was used was used to test the
    to test the normality of homogeneity of
    two samples. variance of two
    samples.

    A parametric test was used if


    IBM SPSS Statistics 21.0 (SPSS variables in the two groups
    Corporation, Chicago, IL, USA) satisfied homogeneity of
    was used for data analysis. variance. If homogeneity of
    Values of P<0.05 were variance was not present, a
    considered statistically nonparametric test, such as
    significant. the Kolmogorov–Smirnov Z-
    rank test, was used.
    Establishing the Receiver Operating
    Characteristic Curve
    The receiver operating
    characteristic (ROC) curve is also
    referred to as a sensitivity curve

    We calculated the area


    under the ROC curve
    (AUC) for each test
    separately to determine
    which test had the largest
    AUC.

    The closer to the


    upper left corner of
    the ROC curve, the
    higher the accuracy of
    this test.
    RESULTS

    •Homogeneity of variance and normal distribution

    Only age in the PPROM group and electrical


    conductivity in each group showed a normal
    distribution, with α=0.5 as the test level
    RESULTS

    •Comparison of variables

    • Age was significantly younger in the full-term group compared with


    the other three groups (all P<0.05).

    • Occult blood, KET, and the RBC count were significantly higher,
    and electrical conductivity was significantly lower in the PPROM
    group compared with the other three groups (all P<0.05).

    • Bacteria and crystals were significantly different between the


    PPROM group and the PROM and full-term groups (all P≤0.05).

    • SG, EC, and yeast were significantly different between the PPROM
    and PROM groups (all P<0.05), while protein, pH, and small round
    cells were significantly different between the PPROM and full-term
    groups (all P<0.05).
    RESULTS
    •ROC Curve

    • We found that bacteria


    had the largest AUC
    (0.696). The AUC for
    electrical conductivity
    was 0.596 and that for
    crystals was 0.577.
    RESULTS
    •ROC Curve
    RESULTS

    •Predicted Value of Indicators

    • When the variable bacteria had a cutoff of 130.15, the sensitivity was
    58%, the specificity was 79%, the PPV was 73.4%, the NPV was 65.3%,
    +LR was 2.76, and –LR was 0.53
    DISCUSSION

    By analyzing routine urine data, we found significant


    differences in various variable among the groups. We
    found that PROM was more likely to occur with age.

    Occult blood and the RBC count were significantly


    higher in the PPROM group compared with the other
    groups.

    The WBC count was lower in the normal (nonpregnant)


    group than in the other three groups, but no differences
    were observed among the pregnant groups.

    The amount of bacteria was significantly lower in the


    PPROM group than in the PROM and full-term groups, but
    there was no difference between the PPROM and normal
    groups.
    CONCLUSIONS

    This study shows that a routine urine examination is of certain value in


    early diagnosis of PPROM. In particular, a reduction in the amount of
    bacteria in the urine sample is a high-risk factor, indicating the loss of
    normal bacterial floral diversity.
    Our findings could also be helpful for selecting the most appropriate time
    for treatment or termination of pregnancy, which has important
    significance for improving the prognosis of mothers and children.
    A routine urine test, especially for bacterial counts, has certain predictive
    value for PROM.
    THANK YOU FOR YOUR ATTENTION 

    ANY QUESTION?

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