Establishment of a prediction method for premature rupture of membranes in term pregnancy using active ceruloplasmin in cervicovaginal secretion as a clinical marker.
OBJECTIVE
Term pregnancy complicated by premature rupture of membranes (PROM) is thought to be associated in part with subclinical infection, and places mothers and neonates at an increased risk for several complications. Therefore, perinatal care would be greatly helped if a reliable clinical measure were available for predicting the incidence of PROM.


METHODS
One hundred and ninety-six pregnant women who consented to enter this study were screened using a method developed to assess active ceruloplasmin in cervicovaginal secretion as a clinical marker for predicting the incidence of PROM. Cervicovaginal secretions were obtained from the cervical canal at about 36 weeks of pregnancy. The active ceruloplasmin level in the cervicovaginal secretion was measured using an original enzyme-linked immunoabsorbent assay.


RESULTS
Of 196 women, 27 women (13.8%) developed PROM and 169 women (86.2%) did not develop PROM. Active ceruloplasmin in the cervicovaginal secretion was significantly higher in the PROM group than in the non-PROM group (P < 0.001). Analysis using receiver-operating characteristic curves showed that the active ceruloplasmin level (1420.0 ng/mL) proved to be the proper cut-off value to best predict the incidence of PROM.


CONCLUSIONS
Active ceruloplasmin in the cervicovaginal secretion might be a reliable clinical marker for term PROM.
Ogino
Mitsuharu
M
Department of Obstetrics and Gynecology, International Medical Center of Japan, Tokyo, Japan. mogino@cb3.so-net.ne.jp
Hiyamuta
Shuichi
S
Takatsuji-Okawa
Masako
M
Tomooka
Yasuhiro
Y
Minoura
Shigeki
S
D015415:Biomarkers / Q000378:metabolism; D002570:Ceruloplasmin / Q000378:metabolism*; D002582:Cervix Mucus / Q000378:metabolism*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000378:metabolism*; D006801:Humans; D015151:Immunoblotting; D011237:Predictive Value of Tests; D011247:Pregnancy; D012372:ROC Curve
D015415:Biomarkers; D002570:Ceruloplasmin