Role of Vaginal Fluid Aspartate Aminotransferase and Alanine Aminotransferase in the Diagnosis of Pre-Labor Rupture of Membranes

Document Type : Original Article


1 Department of Obstetrics and Gynecology, El-Senbellawein General Hospital, Ministry of Health, Egypt

2 Department of Obstetrics and Gynecology, Damietta Faculty of Medicine, Al-Azhar University, Egypt



Background: Pre-labor rupture of membrane is a common obstetric complication. Rapid and good diagnosis is needed to prevent bad obstetric complication and unneeded hospitalization.
Aim of work: The aim of this study was to evaluate the reliability of aspartate aminotransferase [AST] and alanine aminotransferase [ALT] enzymes measurement in vaginal washing fluid for the diagnosis of pre-labour rupture of membranes.
Patient and method: This case-control study was carried out in two departments of Obstetrics and Gynecology [Al-Azhar University Hospital, New Damietta and Senbellawein General Hospital], between March 2019 and December 2020. It included 90 pregnant women at gestational age 30-40 weeks. They were divided into two equal groups. Group І [case group, PROM group]: included women with diagnosis of rupture of membranes confirmed by visualization of amniotic fluid passing from the cervical canal, and Group ІІ [control group] included women without any complaint or complication. All were clinically evaluated and the vaginal fluid was aspirated for laboratory analysis.
Results: Results revealed significant differences between the studied groups. The mean AST level in the PROM group was 18.84±5.74 and 3.33±1.29 in the control group [p <0.001]. The optimal cutoff concentration for AST levels in vaginal secretions is >8 IU/L. The mean ALT levels were 5.09±2.1 in the PROM and 1.13±0.94 in the control group, with significant difference between groups [p <0.001]. The cutoff value of >2.5 IU/L is optimal.
Conclusion: Vaginal fluid Aspartate aminotransferase [AST] and Alanine aminotransferase [ALT] have high sensitivity and high negative predictive value. So, they are considered a good screening tests for detection of PROM. Also measuring vaginal fluid AST and ALT levels are cheaper, faster, available and reliable method for detection of pre-labor rupture of membranes. 


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