Abstract
Objective: The study objective was to assess the utility of placental leucine aminopeptidase (P-LAP) marker for the prediction of delivery in patients presented with threatened preterm labor (TPL).
 Setting: This study was conducted at the Obstetrics and Gynaecology Department of Al-Yarmouk Teaching Hospital in the period from March 2017 to June 2018.
 Type of Study: This is a prospective case control study.
 Methods: This study included 90 pregnant women with gestational age from (28-36+6) weeks; 45 of them who presented with preterm uterine contractions were considered as the study group which was further subdivided into three subgroups according to gestational age 28–31+6 weeks, 32– 33+6 weeks, and 34–36+6 weeks. The other 45 pregnant women who presented to the hospital for regular antenatal care visit at comparable gestational age to the study group were considered as the control group. Hence, this study aimed to assess the serum level of P-LAP in both groups and compare it between those delivered preterm from term to assess its applicability as a predictor of preterm labor.
 Results: Serum level of P-LAP in pregnant women presented with TPL was found to be significantly lower in those delivered preterm (p<0.001), compared to those continued to term and control group especially in gestational ages ≥32 weeks, while the study found P-LAP level to be statistically insignificant in gestational age <32 weeks (p=0.052). The cutoff point for P-LAP serum level was = 21 (IU/ml) that below it, the pregnant women with TPL most probably deliver before 37 weeks of gestation with Sensitivity (85.7%) Specificity (90.3%), Positive predictive value (80.0%) Negative predictive (93.3%).
 Conclusion: The serum level of P-LAP was lower in women delivered preterm than those delivered at term, so it can be used as one of the markers for the prediction of preterm delivery, especially at gestational age >32 weeks.
Highlights
Term pregnancy is defined as gestational age from 37+0 to 41+6 weeks, whereas preterm birth (PTB) is defined as delivery of a baby before 37 completed weeks of pregnancy [1]
Aim of study The objective of this study is to evaluate the accuracy of serum level of Placental leucine aminopeptidase (P-LAP)\oxytocinase in pregnant women who presented with Threatened preterm labor (TPL) as a predictor of preterm delivery
A total of 90 pregnant women (45 preterms and 45 controls) were included in the study; their age ranged from 21 to 34 years, their parity was from primigravida up to 5 parities, their gestational ages at presentation were from 28 to 36+6 weeks, control group collected at comparable gestational age(28 – 36+6) to study group (Table 1)
Summary
Term pregnancy is defined as gestational age from 37+0 to 41+6 weeks, whereas preterm birth (PTB) is defined as delivery of a baby before 37 completed weeks of pregnancy [1]. The onset of labor may be diagnosed by documented uterine contractions (at least once in every 10 min) and documented cervical change with an estimated cervical length of 2 cm. Threatened preterm labor (TPL) is diagnosed when there are documented regular uterine contractions but no evidence of cervical change [2,3]. For early detection of preterm labor, various screening tools have been used including monitoring of uterine activity, assessment of cervical length by ultrasound, cervical fetal fibronectin measurement, and the presence of bacterial vaginosis in early pregnancy [12,13]. Studies on oxytocinase’s role in regulating blood pressure and uterine contraction during pregnancy have been carried out focusing on the possibility to use it in the treatment of preterm labor and pre-eclampsia [19,20,21]
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