Evaluation of the Role of Plasma Procalcitonin in Prediction of Intra-amniotic Infection in Patient with Preterm Premature Rupture of Membrane A cohort study

Abstract

This current cohort study was conducted in Ain Shams University Maternity hospital starting from June 2014 to May 2015. Total 50 pregnant women with preterm premature rupture of membrane which confirmed by sterile cusco speculum examination were divided into two groups according to level of WBCs and CRP group(1) with normal WBCs and CRP and group(2) with subclinical infection. Blood samples were obtained from them before antibiotic administration to detect the plasma procalcitonin level and then follow up of these patients by CRP, WBCs and fever charts then measurement of the CRP of the baby was done to detect the cutoff value of procalcitonin as a predictive indicator of clinicalintra-amniotic infection in patients with preterm premature rupture of membrane. There was increase in procalcitonin in patients with PPROM the mean value of maternal plasma procalcitonin concentration was higher in patients with clinical infection than its concentration in patients without infection or with subclinical infection as its level was in group(1) and group(2) were 334.3 pg/ml and 392.8 pg/ml respectively with P-value 0.042 which is significant between the studied cases and its level in group (1) between patients with clinical infection and without infection was 360.9pg/ml and 318.3pg/ml respectively with P-value was 0.034 and with cutoff value was >270pg/ml with sensitivity, specificity, PPV, NPV was 90%, 64%, 66.2% and 90% respectively, also its level between patients with clinical and with subclinical infection in group(2) was 407.2pg/ml and 370.3pg/ml respectively with P-value was 0.032 and cutoff value was >278pg/ml with sensitivity, specificity, PPV, NPV was 93%, 66%, 68.5% and 92.3% respectively. Moreover, procalcitonin was significant predictor of neonatal infection with cutoff value was >291pg/ml with sensitivity, specificity, PPV, NPV were 96%, 75%, 70% and 92% respectively. Otherwise, there was no significant difference as regard of duration of rupture of membrane and neonatal intensive care unit(NICU) admission as the P-value was 0.804, 0.340 respectively.