TY - JOUR ID - TI - The Value of Free Thyroid Hormones and Aspartate Aminotransferase in Vaginal Washing Fluid for Detection of Preterm Pre-Labor Rupture of Membrane AU - Maha Mohamed Jasim Al-Bayati*, Eaman Marouf Muhammad**, Athmar Maamon Salman** PY - 2019 VL - 18 IS - 1 SP - 52 EP - 58 JO - Iraqi Postgraduate Medical Journal المجلة العراقية للاختصاصات الطبية SN - 83601608 98932708 AB - ABSTRACT:BACKGROUND:Preterm pre-labor rupture of membrane occurs in about 2% of all pregnancies. The most frequentconsequences of preterm pre-labor rupture of membrane is preterm delivery, sepsis and pulmonaryhypoplasia. The correct diagnosis of preterm pre-labor rupture of membrane is crucial and successfulmanagement will be based upon it.OBJECTIVE: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 pretermpre-labor rupture of membrane.STUDY DESIGN: A case - control study.SETTING: :This study was conducted at department of Obstetrics and Gynecology of AL-Yarmoukteaching Hospital and National center for DiabetesPATIENTS, MATERIALS AND METHODS:It included hundred pregnant women with a gestational age ranging between 24 - 36+6 weeks. Theywere divided into two groups, the study group which included fifty pregnant women presented withpreterm pre-labor rupture of membrane and the control group which includes fifty pregnant womenwithout any complaint, matched for gestational age. All women underwent sterile speculum vaginalexamination. Free triiodothyronine and free thyroxin levels were measured by using Enzyme immuneassay method, and aspartate aminotransferase level was measured by using colorimetric method, invaginal washing fluid.RESULTS: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 operatingcharacteristic curve (ROC) analysis (P<0.001). ROC curve analysis showed that free T3 validityresults in predicting preterm pre labor rupture of membrane among pregnant women were (cut-off1.07pg/ml, sensitivity 88%, specificity 76% and accuracy 82%), free T4 validity results were (cutoff0.055pg/ml, sensitivity 84%, specificity 80% and accuracy 82%) and AST validity resultswere (cut-off 4.9IU/L, sensitivity 52%, specificity 80% and accuracy 66%).CONCLUSION:Measurement of aspartate aminotransferase free triiodothyronine , and thyroxin in vaginal washingfluid of suspected and diagnosed patient presented with preterm pre labor rupture of membranefound to be a useful markers for the diagnosis of preterm pre labor rupture of membrane..

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