DIAGNOSTIC ACCURACY OF HIGH ALANINE AMINOTRANSFERASE (ALT) LEVELS IN PREDICTING ADVERSE MATERNAL OUTCOME IN PRE-ECLAMPSIA
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Keywords
preeclampsia, alanine aminotransferase, adverse maternal outcome
Abstract
Introduction: Elevations of the liver enzymes aspartate aminotransferase and alanine aminotransferase (ALT) during the first 20 weeks of pregnancy are associated with an increased chance of experiencing severe preeclampsia in the latter half of pregnancy.
Objectives: The study's goal was to ascertain if elevated levels of ALT could accurately predict unfavorable outcomes for mothers with pre-eclampsia, with severe pre-eclampsia being the gold standard.
Materials & Methods: This descriptive, cross-sectional validation study was conducted at the Department of Obstetrics & Gynecology, BBH, Rawalpindi, from April 30th, 2019, to October 29th, 2019, enrolled 247 pre-eclamptic women aged 18 to 40 years. Patients having several pregnancies, chronic hypertension, renal illness, chronic liver disease, and HELLP syndrome were among those excluded. All subjects had their serum ALT levels measured in the Institutional Pathology laboratory by a consultant pathologist who had completed at least three post-fellowship years of service. The researcher observed maternal outcomes up until delivery and then managed them as needed after that.
Results: There were 07 False Positive results and 133 True Positive results in that research study. Of the 107 patients who tested negative for ALT, 11 (False Negative) had a poor maternal outcome, while 96 (True Negative) did not (p=0.0001). The total specificity, sensitivity, positive predictive value, negative predictive value, and diagnostic accuracy in predicting an adverse maternal outcome in pre-eclampsia were 92.36%, 93.30%, 95.0%, 89.72%, and 92.71% when high ALT levels were present.
Conclusion: This study found that high ALT levels have a fairly high diagnostic accuracy in predicting a poor maternal outcome in pre-eclampsia.
References
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Dr Maryam Noor Malik
Senior Registrar, Shifa International Hospital, Islamabad
Dr Mehak Asim Khan
University Hospital Kerry Tralee Ireland
Dr Wajeeha Shafique
Medical Officer, Benazir Bhutto Hospital, Rawalpindi
Dr Asma Achakzai
Assistant Professor, Gynae and Obstetrics Department, Jam Ghulam Qadir Hospital, Balochistan,
Dr Hamaida Akbar
Lahore Medical & Dental College, Lahore
Dr Maryam Ahmad Qureshi
Shifa College of Medicine/Shifa International Hospital Islamabad
Dr Mohammad Ahmad Abbasi
Rashid Latif Khan University Medical College Lahore, Punjab, Pakistan
Dr Tehreem Ali
Rashid Latif Khan University Medical College Lahore, Punjab, Pakistan,
Dr Misbah Azhar
Aziz Fatima Medical College &Trust Hospital, Faisalabad