Maternal-Fetal Medicine Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
Department of Obstetrics and Gynecology, Shiraz University of Medical Sciences, Shiraz, Iran.
Int J Gynaecol Obstet. 2019 Oct;147(1):83-88. doi: 10.1002/ijgo.12907. Epub 2019 Jul 25.
To determine the predictive value of procalcitonin, C-reactive protein (CRP), and white blood cells (WBC) for chorioamnionitis among women with preterm premature rupture of membranes (PPROM).
A prospective cross-sectional study of all women with singleton pregnancy and PPROM admitted to a referral hospital in Shiraz, Iran, from 2016 to 2018. All women were hospitalized until delivery. The incidence of chorioamnionitis was recorded. Maternal serum CRP, procalcitonin, and WBC were measured on the day of admission and the day before termination of pregnancy. The diagnostic accuracy of each test was evaluated by receiver operator characteristic (ROC) curve analysis.
Overall, 75 women with PPROM were included in the study. After termination of pregnancy, 34 (45.3%) were diagnosed with clinical chorioamnionitis. Those with chorioamnionitis had significantly higher serum levels of CRP both on admission (P=0.004) and before termination of pregnancy (P<0.001). The area under the curve for last CRP was 0.78 (95% confidence interval, 0.57-0.84), indicating moderate accuracy. Procalcitonin and WBC had low accuracy to predict chorioamnionitis.
Among CRP, procalcitonin, and WBC, maternal serum CRP was found to be the most accurate predictor of chorioamnionitis among women with PPROM.
确定降钙素原、C 反应蛋白（CRP）和白细胞（WBC）对胎膜早破并发早产孕妇绒毛膜羊膜炎的预测价值。
这是一项 2016 年至 2018 年在伊朗设拉子的一家转诊医院进行的前瞻性病例对照研究，纳入所有单胎妊娠且胎膜早破的孕妇。所有孕妇均住院至分娩。记录绒毛膜羊膜炎的发生率。入院当天和终止妊娠前一天检测母体血清 CRP、降钙素原和 WBC。通过受试者工作特征（ROC）曲线分析评估每种检测的诊断准确性。
共有 75 例胎膜早破孕妇纳入研究。终止妊娠后，34 例（45.3%）诊断为临床绒毛膜羊膜炎。有绒毛膜羊膜炎的孕妇入院时（P=0.004）和终止妊娠前（P<0.001）的 CRP 血清水平显著更高。最后 CRP 的曲线下面积为 0.78（95%置信区间，0.57-0.84），表明具有中等准确性。降钙素原和 WBC 预测绒毛膜羊膜炎的准确性较低。
在 CRP、降钙素原和 WBC 中，母体血清 CRP 是预测胎膜早破并发早产孕妇绒毛膜羊膜炎最准确的指标。
