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

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

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