title: Neutrophil granule products: can they identify subclinical chorioamnionitis in patients with preterm premature rupture of membranes?
abstract: OBJECTIVE
  Our purpose was to determine whether maternal plasma levels of neutrophil granule products are elevated in patients with chorioamnionitis after preterm premature rupture of membranes (PROM).
  
  
  METHODS
  Fifty-two patients between 24 and 34 weeks' gestation with preterm PROM were included. Plasma samples for defensins and lactoferrin were collected throughout latency. Fifty-two control subjects between 26 and 30 weeks' gestation were recruited for baseline levels.
  
  
  RESULTS
  Mean control defensin levels were compared with mean defensin levels on admission (668 ng/mL vs 5665 ng/mL, P<.01). Mean defensin levels on admission in patients without chorioamnionitis were compared with those of patients in whom histologic chorioamnionitis developed (520 ng/mL vs 9163 ng/mL, P<.01). The same relationships were not demonstrated for lactoferrin. With use a defensin value of 1500 ng/mL on admission, the sensitivity is 76% and specificity is 94% in predicting histologic chorioamnionitis.
  
  
  CONCLUSIONS
  Maternal plasma levels of defensins are markers of histologic chorioamnionitis in patients after preterm PROM.
authors.affiliation: Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Magee Womens Hospital, University of Pittsburgh, PA, USA. grable@bidmc.harvard.edu
authors.forename: Ian A
authors.initials: IA
authors.lastname: Grable
authors.forename: R Phillips
authors.initials: RP
authors.lastname: Heine
mesh_terms: D000890:Anti-Infective Agents / Q000097:blood*; D002821:Chorioamnionitis / Q000097:blood* / Q000150:complications / Q000175:diagnosis; D003594:Cytoplasmic Granules / Q000378:metabolism; D023082:Defensins / Q000097:blood*; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000097:blood* / Q000150:complications; D005865:Gestational Age; D006801:Humans; D007781:Lactoferrin / Q000097:blood*; D009504:Neutrophils / Q000378:metabolism* / Q000648:ultrastructure; D010920:Placenta / Q000473:pathology; D011247:Pregnancy; D012680:Sensitivity and Specificity; D013997:Time Factors
chemical_list: D000890:Anti-Infective Agents; D023082:Defensins; D007781:Lactoferrin