Preterm pre-labor rupture of membrane occurs in about 2% of all pregnancies. The most frequent
consequences of preterm pre-labor rupture of membrane is preterm delivery, sepsis and pulmonary
hypoplasia. The correct diagnosis of preterm pre-labor rupture of membrane is crucial and successful
management will be based upon it.
To determine whether measurement of vaginal washing fluid aspartate aminotransferase(AST) ,
free triiodothyronine (free T3) and thyroxin(free T4) were useful tests for the diagnosis of preterm
pre-labor rupture of membrane.
STUDY DESIGN: A case - control study.
SETTING: :This study was conducted at department of Obstetrics and Gynecology of AL-Yarmouk
teaching Hospital and National center for Diabetes
PATIENTS, MATERIALS AND METHODS:
It included hundred pregnant women with a gestational age ranging between 24 - 36+6 weeks. They
were divided into two groups, the study group which included fifty pregnant women presented with
preterm pre-labor rupture of membrane and the control group which includes fifty pregnant women
without any complaint, matched for gestational age. All women underwent sterile speculum vaginal
examination. Free triiodothyronine and free thyroxin levels were measured by using Enzyme immune
assay method, and aspartate aminotransferase level was measured by using colorimetric method, in
vaginal washing fluid.
Vaginal washing fluid free T3, free T4 and AST levels were significantly higher in the study group
(1.15), (0.071), (4.9) respectively compared with the control group (0.93), (0.048), (4.5) respectively.
Vaginal washing fluid free T4 having the largest area under the curve on receiver operating
characteristic curve (ROC) analysis (P<0.001). ROC curve analysis showed that free T3 validity
results in predicting preterm pre labor rupture of membrane among pregnant women were (cut-off
1.07pg/ml, sensitivity 88%, specificity 76% and accuracy 82%), free T4 validity results were (cutoff
0.055pg/ml, sensitivity 84%, specificity 80% and accuracy 82%) and AST validity results
were (cut-off 4.9IU/L, sensitivity 52%, specificity 80% and accuracy 66%).
Measurement of aspartate aminotransferase free triiodothyronine , and thyroxin in vaginal washing
fluid of suspected and diagnosed patient presented with preterm pre labor rupture of membrane
found to be a useful markers for the diagnosis of preterm pre labor rupture of membrane.