Prediction of pregnancy outcome by limulus amoebocyte lysate (LAL) test in non pregnant women with poor obstetric history

Objective: to evaluate the prognostic value of Limulus Amoebocyte Lysate (LAL) Test in prediction of pregnancy outcome in women with poor obstetric history.
Materials and Methods: non pregnant females with history of abortions and or preterm labor were included. Measurement of bacterial endotoxin in menstrual effluent was done using the Limulus Amoebocyte Lysate (LAL) Test. Sixty eight women got pregnant within a year; follow up of these women was done to assess the outcome of pregnancy and compared to results of LAL test.
Results: There was a statistically significant correlation between LAL test level and the occurrence of pregnancy (p < 0.05). Spontaneous preterm labor and abortion were 16.6% in samples with endotoxin =150 pg/ml while, they were 85.2% with endotoxin > 150pg/ml. Measurement of endotoxin level had a sensitivity of 79.3%, specificity of 89.2% for prediction of occurrence of preterm labor and abortion. It has positive predictive value of 85.2% and negative predictive value of 85.4% and overall accuracy of 85.3%.
Conclusion: Limulus Amoebocyte Lysate (LAL) Test in menstrual blood may be considered as a prognostic marker for pregnancy outcome in women with history of previous abortions and or preterm labor.