Comparison between Leukocyte Esterase Activity (LEA) and Histopathology Examination in Identifying Chorioamnionitis Cases

Uji Diagnostik Leukocyte Esterase Activity (LEA) terhadap Histopatologi pada Kasus korioamnionitis

  • Putri H Novianesari Faculty of Medicine Universitas Sriwijaya Dr. Mohammad Hoesin Hospital Palembang
  • Nuswil Bernolian Faculty of Medicine Universitas Sriwijaya Dr. Mohammad Hoesin Hospital Palembang
  • Henni Maulani Faculty of Medicine Universitas Sriwijaya Dr. Mohammad Hoesin Hospital Palembang
  • Afifa Ramadanti Faculty of Medicine Universitas Sriwijaya Dr. Mohammad Hoesin Hospital Palembang
  • Theodorus Theodorus Faculty of Medicine Universitas Sriwijaya Dr. Mohammad Hoesin Hospital Palembang

Abstract

Objective: To compare sensitivity and specificity of LEA to histopathology examination in diagnosing chorioamnionitis.
Methods: We compared diagnostic tests in dr. Mohammad Hoesin hospital, Palembang, from September 2015 to April 2016. Ninety-one pregnant women were included. LEA and histopathology examination were carried out with neonatal sepsis as main outcome. Data were analysed by SPSS version 21.0 and Med-calc statistic.
Results: Chorioamnionitis was detected in 54 (77.1%) patients with gestational period ≥37 weeks and in 16 (22.9%) patients with gestational period <37 weeks. Duration of membrane rupture was significantly associated with chorioamnionitis (p = 0.001 and p = 0.011). Neonatal sepsis was also significantly associated with chorioamnionitis in both groups (p = 0.014 and p = 0.036). LEA value with cut-off point >0.5 was able to significantly predict chorioamnionitis with 98.6% sensitivity and 95.2% specificity, providing better accuracy in diagnosing chorioamnionitis in preterm pregnancy group.
Conclusion: LEA had a very good predictive value for chorioamnionitis with better accuracy in diagnosing chorioamnionitis in preterm pregnancy.
Keywords: Chorioamnionitis, Histopathology, Leukocyte esterase activity, Neonatal sepsis, Salafia criteria
 
 
 
Tujuan: Membandingkan sensitifitas dan spesifisitas diagnosis korioamnionitis antara pemeriksaan Leukocyte esterase activity (LEA) terhadap histopatologi.
Metode: Penelitian uji diagnostik dilakukan di RSUP dr. Mohammad Hoesin Palembang selama periode September 2015 – April 2016,  91 wanita hamil yang memenuhi kriteria inklusi selanjutnya dilakukan pemeriksaan LEA, Histopatologi dan luaran sepsis neonatorum. Data kemudian dianalisis dengan menggunakan software SPSS versi 21.0 dan Med-calc statistic.
Hasil: Korioamnionitis terdeteksi pada 54 (77,1%) pasien dengan usia gestasi ≥37 minggu dan 16 (22,9%) pada usia gestasi <37 minggu. Durasi lamanya pecah ketuban akan berpengaruh secara signifikan terhadap kejadian korioamnionitis (p = 0,001 dan p = 0,011), Sepsis neonatorum juga secara signifikan berhubungan dengan kejadian korioamnionitis pada kedua kelompok (p = 0,014 dan p = 0,036). Kadar LEA dengan cut off point >0,5 secara signifikan mampu memprediksi kejadian korioamnionitis dengan sensitivitas 98,6%, spesifisitas 95,2% dan nilai akurasi yang lebih baik ditemukan dalam penegakan diagnosis korioamnionitis pada kelompok kehamilan preterm.
Kesimpulan: Pemeriksaan LEA memiliki kekuatan prediksi yang sangat baik terhadap kejadian korioamnionitis dengan akurasi yang lebih baik dalam mendiagnosis korioamnionitis pada kehamilan preterm.
Kata kunci: Korioamnionitis, Histopatologi, Leukocyte Esterase Activity,Sepsis Neonatorum, Kriteria Salafia

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Author Biographies

Nuswil Bernolian, Faculty of Medicine Universitas Sriwijaya Dr. Mohammad Hoesin Hospital Palembang
Department of Obstetric and Gynecology
Henni Maulani, Faculty of Medicine Universitas Sriwijaya Dr. Mohammad Hoesin Hospital Palembang
Department of Pathology Anatomy
Afifa Ramadanti, Faculty of Medicine Universitas Sriwijaya Dr. Mohammad Hoesin Hospital Palembang
Department of Pediatric
Theodorus Theodorus, Faculty of Medicine Universitas Sriwijaya Dr. Mohammad Hoesin Hospital Palembang
Research and Public Health Unit
Published
2019-01-21
How to Cite
NOVIANESARI, Putri H et al. Comparison between Leukocyte Esterase Activity (LEA) and Histopathology Examination in Identifying Chorioamnionitis Cases. Indonesian Journal of Obstetrics and Gynecology, [S.l.], p. 21 - 27, jan. 2019. ISSN 2338-7335. Available at: <http://inajog.com/index.php/journal/article/view/823>. Date accessed: 22 feb. 2019. doi: https://doi.org/10.32771/inajog.v7i1.823.
Section
Research Article