Maternal C-reactive protein at hospital admission is a simple predictor of funisitis in preterm premature rupture of membranes.
OBJECTIVE
To analyze the prognostic value of maternal serum C-reactive protein (CRP) in predicting funisitis in patients with preterm premature rupture of membranes (pPROM).


METHODS
66 patients (gestational age 24-33 weeks) hospitalized 1-12 h after pPROM were enrolled. White blood cell count (WBC), platelet count (PLT) and plasma concentration of CRP were assessed every 3 days. Histological evidence of chorioamnionitis and funisitis was obtained post-partum. Receiver operating characteristic (ROC) curves were employed to evaluate the role of maternal CRP in predicting funisitis.


RESULTS
Funisitis was found in 24 patients (36.3%); 42 patients (63.7%) without funisitis were considered as controls. PLT and WBC at admission and before delivery did not show significant differences and were not statistically different between the two groups. Patients with funisitis had significantly higher CRP levels both at admission to hospital and 24- 48 h before delivery. ROC curve analysis showed that CRP at admission (area under the curve: 0.671, p = 0.021) and before delivery (area under the curve: 0.737, p = 0.001) are predictive of funisitis.


CONCLUSIONS
High maternal serum CRP levels (>20,000 µg/l) in pPROM patients at admission to hospital may be an early marker which indicates, with a good diagnostic performance, the presence of funisitis.
Department of Gynecology and Obstetrics, University of Rome Sapienza, Policlinico Umberto I, Rome, Italy. giuseppina.perrone@gmail.com
Giuseppina
G
Perrone
Maurizio M
MM
Anceschi
Oriana
O
Capri
Paola
P
Galoppi
Sabrina
S
Pizzulo
Matteo
M
Buccheri
Roberto
R
Pascone
Italo
I
Nofroni
Roberto
R
Brunelli
D000328:Adult; D002097:C-Reactive Protein / Q000032:analysis*; D002585:Cesarean Section / Q000706:statistics & numerical data; D002821:Chorioamnionitis / Q000097:blood* / Q000209:etiology / Q000473:pathology; D036861:Delivery, Obstetric; D003955:Diagnostic Tests, Routine; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000097:blood*; D005865:Gestational Age; D006801:Humans; D007958:Leukocyte Count; D010976:Platelet Count; D011247:Pregnancy; D011379:Prognosis; D012372:ROC Curve; D012680:Sensitivity and Specificity
D002097:C-Reactive Protein