title: Predictive value of aspartate aminotransferase and alanine aminotransferase levels in vaginal fluid for the diagnosis of premature rupture of membranes.
abstract: BACKGROUND
  Preterm premature rupture of membranes (PPROM) occurs in 3% of pregnancies and 30-40% of preterm labors are related to this problem. Early diagnosis of PPROM is very important due to its impact on pregnancy outcomes.
  
  
  OBJECTIVE
  To determine the diagnostic value of aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels in vaginal fluid for the diagnosis of preterm premature rupture of membranes as a non-invasive and available test.
  
  
  METHODS
  A total of 148 pregnant women between the 26(th)-36(th) gestational weeks were enrolled in the study. 74 patients were in PROM group and 74 in control group. AST and ALT levels in vaginal fluid were measured in each group. Mann Whitney U-test was used to compare AST and ALT levels in each group.
  
  
  RESULTS
  The mean of AST level in vaginal fluid was 12.77±10.06 in PROM group vs. 6.91±10.92 in control group (p<0.001), while there were no significant difference between ALT levels in PROM group 1.51±3.17 and control group 0.89±1.15 (p=0.49). Optimal cut point of AST for the diagnosis of PROM was 4.5 IU/L in this study. The sensitivity, specificity, positive and negative predictive values were 82.4%, 63.5%, 69.32% and 78.33% respectively.
  
  
  CONCLUSIONS
  According to the findings of this study, measurement of AST level in vaginal fluid can be used as a reliable test for diagnosis of PROM, but there is no good cut point for ALT level that can be practically used.
authors: Reproductive Health Research Center, Department of Obstetrics and Gynecology, Guilan University of Medical Sciences, Rasht, Iran.
authors: Maryam
authors: M
authors: Asgharnia
authors: Reproductive Health Research Center, Department of Obstetrics and Gynecology, Guilan University of Medical Sciences, Rasht, Iran.
authors: Fariba
authors: F
authors: Mirblouk
authors: Guilan University of Medical Sciences, Rasht, Iran.
authors: Fatemeh
authors: F
authors: Salamat
authors: Guilan University of Medical Sciences, Rasht, Iran.
authors: Babak
authors: B
authors: Ashrafkhani
authors: Reproductive Health Research Center, Department of Obstetrics and Gynecology, Guilan University of Medical Sciences, Rasht, Iran.
authors: Zahra
authors: Z
authors: Dirbaz
keywords: Alanine aminotransferase; Aspartate aminotransferase; Premature rupture of membranes