Aspartate aminotransferase and free thyroid hormones in vaginal washing fluid as markers for preterm pre-labor rupture of membranes

作者：Farag Amr H^*; Elghetany Sherif S; Elkashif Mohamed S

来源：Journal of Obstetrics and Gynaecology Research, 2015, 41(9): 1352-1356.

DOI：10.1111/jog.12730

• aspartate aminotransferase
• preterm pre-labor rupture of the membranes
• thyroid hormone
• vaginal washing fluid

Aim: To evaluate the diagnostic value of vaginal fluid aspartate aminotransferase (AST), free triiodothyronine (T-3) and free thyroxine (T-4) in women with preterm pre-labor rupture of membranes (PPROM).
Methods: A case-control study was carried out of 100 women: 50 with PPROM (study group) and 50 age-, gestational age-and weight-matched women with intact membranes (control group). All women underwent sterile speculum vaginal examination. The vaginal posterior fornix was irrigated and the retrieved fluid was sent for AST, free T-3 and free T-4 assays.
Results: Median vaginal fluid free T-3, free T-4 and AST were significantly higher in the PPROM group compared with the control group, with vaginal fluid free T-4 having the largest area under the curve on receiver operating characteristic curve analysis (P<0.001). Sensitivity, specificity, positive and negative predictive values for free T-3 (cut-off, 1.06 pg/mL) were 88%, 70%, 74.6% and 85.4%, respectively, while those for free T-4 (cut-off 0.063 ng/dL) were 86%, 72%, 75.4% and 83.7%, and those for AST (4.5 IU/L) were 56%, 70%, 65.1% and 61.4%, respectively. Vaginal fluid AST had less diagnostic accuracy when compared with either free T-3 or free T-4.
Conclusions: Vaginal fluid AST, free T-3 and free T-4 seem to be useful and simple markers in diagnosis of PPROM.

• 出版日期2015-9