Utilidad de la medición de aminotransferasas en flujo vaginal para el diagnóstico de rotura prematura de membranas

Objective

To establish the usefulness of measuring aminotransaminases in vaginal fluid in the diagnosis of premature rupture of membranes.

Material and methods

A study was conducted on 270 pregnant women who were seen in obstetrics emergency department of the Hospital Central “Dr. Urquinaona”, Maracaibo, Venezuela. They were divided into two groups, consisting of patients with premature rupture of membranes (group A), and pregnant women with intact membranes (group B) considered as controls. General characteristics, values of aminotransferases in vaginal fluid, and diagnostic efficacy were evaluated.

Results

Gestational age at the time of determining aminotransferases in vaginal fluid was 28.2 ± 7.2 weeks in group A, and 27.5 ± 7.3 weeks in group B (P = ns). There were no significant differences in other general characteristics (P = ns). Patients in group A showed significant higher concentrations of alanine transferase and aspartate transaminase in vaginal fluid compared with pregnant women in group B (P < .05). Alanine transferase showed an area under the curve value of 0.88. A cut-off point of 2 IU/L showed a sensitivity of 82.9%, specificity of 92.5%, positive predictive value of 91.8%, and negative predictive value of 84.4%. Aspartate transaminase showed an area under the curve value of 0.81. A cut-off point of 13 IU/L showed an area under the curve value of 0.96, with a sensitivity of 60.0%, specificity of 94.0%, positive predictive value of 91.0%, and negative predictive value of 70.1%.

Conclusions

Measurement of aminotransferases concentrations in vaginal fluid is a useful diagnosis tool for premature rupture of membranes.