Are vaginal fluid procalcitonin levels useful for the prediction of subclinial infection in patients with preterm premature rupture of membranes?
OBJECTIVE
To compare vaginal fluid procalcitonin concentrations in cases of preterm premature rupture of membranes (pPROM) and premature rupture of membranes (PROM) at term, and to determine whether the procalcitonin concentrations are of value in the diagnosis of pPROM cases suspected of subclinical intrauterine infection or in the prediction of the pPROM-to-delivery interval.


METHODS
Forty-eight patients with pPROM and 30 with PROM at term were enrolled in this study. In pPROM group, analysis was conducted of procalcitonin concentrations with reference to serum leucocytosis, serum C-reactive protein levels and vaginal fluid culture, as well as to the presence/absence of neonatal congenital infection or histological chorioamnionitis. The outcomes of pPROM cases were also recorded with reference to pPROM-to-delivery interval.


RESULTS
Procalcitonin levels in the pPROM group were significantly higher than in cases of amniorrhexis at term (1.50 vs 0.83 ng/mL; P < 0.001). In the pPROM group procalcitonin concentrations between the patients with and without positive laboratory indices of infection were comparable. Also, no significant correlation was observed between procalcitonin and leucocytosis (r = -0.14; P = 0.33) or C-reactive protein (r = -0.17; P = 0.24). Procalcitonin concentrations of patients who gave birth to newborns with infection were comparable to those in women whose newborns were healthy. In patients with histological chorioamnionitis, procalcitonin concentrations were comparable to those without inflammatory changes.


CONCLUSIONS
These findings suggest that the value of vaginal fluid procalcitonin determinations is unsatisfactory in the diagnostics of pPROM cases suspected of subclinical intrauterine infection, as well as for the prediction of pPROM-to-delivery interval, newborn's congenital infection or histological chorioamnionitis.
Torbé
Andrzej
A
Department of Obstetrics and Perinatology, Pomeranian Medical University, Szczecin, Poland. torbea@wp.pl
Czajka
Ryszard
R
D000328:Adult; D001826:Body Fluids / Q000378:metabolism*; D002097:C-Reactive Protein / Q000378:metabolism; D002116:Calcitonin / Q000378:metabolism*; D015740:Calcitonin Gene-Related Peptide; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000378:metabolism*; D006801:Humans; D007231:Infant, Newborn; D007958:Leukocyte Count; D007752:Obstetric Labor, Premature / Q000517:prevention & control; D011237:Predictive Value of Tests; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000378:metabolism*; D011498:Protein Precursors / Q000378:metabolism*; D012680:Sensitivity and Specificity; D014621:Vagina / Q000378:metabolism*
C000606589:CALCA protein, human; D011498:Protein Precursors; D002116:Calcitonin; D002097:C-Reactive Protein; D015740:Calcitonin Gene-Related Peptide