Comparative Study Between Human Chorionic Gonadotropin and Prolactin Hormones in Cervicovaginal Secretions as Predictors of Preterm Labor

Abstract

SUMMARY P TB continues to be the leading cause of perinatal morbidity& mortality throught the world. Despite advances in perinatal care, the incidence of PTL has not decreased significantly over the past 40 years. The use of biological markers to enhance the clinical accuracy in predicting PTB has been recently proposed. In this study β-HCG & PRL values in cervicovaginal secretions were used as a predictive markers for PTL. In this study. A total of 100 pregnant women were included, between (28-34 wks) of gestational age. Patients were divided into 2 groups: Group A: Included Study group (n = 50) Evidence of characteristic threatened preterm labor; Regular uterine contractions, cervical dilatation less than 4 cm, Cervical effacement less than 50%. Group B: Included control group (n = 50) Normal pregnancy without any complications. Gestational age were assessed on the basis of the last normal menstrual period and confirmed by sonographic measurements in the first or second trimesters. All women were subjected to full history taking, full general, abdominal and pelvic examination, in addition to special investigation which were cervicovaginal secretion sampling in order to measure β-HCG & PRL level by automated enzyme immunoassay sytem AIA-360 TOSOH corporation shiba-Koen first bidg, 3-8-2 Shiba Minato. Ku Tokyo 105-8623, Jaban. The patients were followed up till the time of delivery & gestational age at delivery is determined. It was found that β-HCG in cervicovaginal secretion significantly higher in study group compared to control group. This was of high statistical significance. PRL in cervicovaginal secretion was significantly higher in study group compared to control group. This was of high statistical significance. In this study the cut off value of β-HCG in cervicovaginal secretions which can discriminate between PTL & term delivery is 29.35 mIu/ml. At this value the specificity is 59%, sensitivity is 86 %. In this study the cut off value of PRL in cervicovaginal secretions which can discriminate between PTL & term delivery is 1.91 ng/ml. At this value the specificity is 57%, sensitivity is 84%. However, this was not constant when compared with other studies, but the common point is the high negative predictive value.