title: [Usefulness of determination of granulocyte elastase plasma level, c-reactive protein and white blood cell count in prediction in intrauterine infection in pregnant women after PROM].
abstract: The main markers of intrauterine infection: C-reactive protein and white blood cell count are dependent on medical management as steroids or antibiotics therapy. Granulocyte elastase is independent variable from influence of tocolysis, steroids, antibiotics, chemiotherapeutics, hours since PROM. The aim of the study was to evaluate and compare the usefulness of determination granulocyte elastase, (EG) C-reactive protein (CRP) and white blood cell count (WBC) in prediction of chorioamninitis in pregnant women after premature rupture of fetal membranes.
  
  
  METHODS
  67 women with single pregnancy between 24-36 week of gestation after PPROM were included into the study group. All women were managed expectantly (tocolysis, antibiotics, steroids, intravaginal chemiotherapeutics, bed rest), maternal and fetal (KTG, USG) vital signs were monitored every day. EG, CRP and WBC blood test were performed every day. Histopathologic examinations of all placentas were performed for chorioamnionitis confirmation or exclusion. Normal range for EG--88 micrograms/l, CRP--15 micrograms/l, WBC--15 x 10(9).
  
  
  RESULTS
  The usefulness of granulocyte elastase plasma serial determination as biochemical marker of chorioamnionitis in cases of PPROM was confirmed: sensitivity--100%, specificity--33%, PPV--64.9%, NPV--100% in comparison with CRP: sensitivity--27%, specificity--80%, PPV--62.5%, NPV--47% and white blood cell count: sensitivity--27%, specificity--66.7%, PPV--50%, NPV-42.5%.
  
  
  CONCLUSIONS
  We confirmed statistical correlation (p < 0.001) between granulocyte elastase plasma level > 88 micrograms/l and histological signs of intrauterine infection in pregnant women after PPROM. Granulocyte elastase determination in plasma is most sensitive indicator of histologic confirmed chorioamnionitis.
authors.affiliation: Kliniki Połoznictwa i Ginekologii Instytutu Matki i Dziecka w Warszawie.
authors.forename: E Małgorzata
authors.initials: EM
authors.lastname: Bańkowska
authors.forename: Jerzy
authors.initials: J
authors.lastname: Leibschang
authors.forename: Adriana
authors.initials: A
authors.lastname: Pawłowska
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism*; D002821:Chorioamnionitis / Q000175:diagnosis* / Q000209:etiology; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000097:blood* / Q000150:complications*; D006801:Humans; D007958:Leukocyte Count; D019272:Leukocyte Elastase / Q000097:blood*; D007962:Leukocytes; D011044:Poland; D011237:Predictive Value of Tests; D011247:Pregnancy; D012680:Sensitivity and Specificity; D013997:Time Factors
chemical_list: D015415:Biomarkers; D002097:C-Reactive Protein; D019272:Leukocyte Elastase