INTRODUCTION: Premature rupture of membranes (PPROM) is a significant obstetric complication, particularly in pregnancies between 28 and 34 weeks of gestation. Early and accurate diagnosis is critical for reducing adverse maternal and neonatal outcomes. This study aimed to compare the diagnostic reliability of vaginal fluid urea and creatinine levels with the Nitrazine test in identifying PPROM.

METHODOLOGY: This comparative study was conducted at the Obstetrics and Gynecology Department, Unit II, Lady Willingdon Hospital, Lahore. A total of 60 pregnant women between 28 and 34 weeks of gestation were enrolled and divided equally into two groups: cases (PPROM confirmed by clinical examination) and controls (no history or suspicion of PPROM). Vaginal fluid samples were collected using sterile techniques and analyzed for urea and creatinine levels. Additionally, the Nitrazine test was performed to compare its diagnostic accuracy. Data were analyzed using SPSS version 26, and statistical significance was set at p ≤ 0.05.

RESULTS: The mean age of participants was 35.4 ± 3.04 years in the case group and

35.2 ± 3.1 years in the control group. The Nitrazine test demonstrated a specificity of 100% and a sensitivity of 87.5%, making it the most accurate diagnostic tool. Vaginal fluid creatinine showed a sensitivity of 66.7%, while urea demonstrated the lowest sensitivity at 56.7%. 

CONCLUSION: Nitrazine test has diagnostic potential  for premature rupture of membranes in pregnant women with gestational ages ranging from 28 to 34 weeks. While urea and creatinine, has limitations in sensitivity and precision. For accurate diagnosis in preventing adverse outcomes for both the mother and fetus, there remains a necessity to identify alternative cost-effective, highly sensitive, and precise biochemical markers that could aid in the identification of PPROM, particularly in challenging cases.

KEYWORDS: Premature Rupture of Membrane (PPROM), Nitrazine Test, Vaginal Fluid Creatinine, Vaginal Fluid Urea, Diagnostic Accuracy.