Procalcitonin for prediction of chorioamnionitis in preterm premature rupture of membranes.
OBJECTIVE
To assess serum procalcitonin (PCT), a marker of monocyte activity, in predicting chorioamnionitis in preterm premature rupture of membranes (PPROM).


METHODS
Prospective cohort study in singleton gestation patients with PPROM between 2 2 + 0 to 3 3 + 6 weeks gestation. Two blood samples were taken - admission and delivery or diagnosis of clinical chorioamnionitis. Maternal serum PCT > 0.1 ng/mL was considered positive. Patients were divided into four groups: clinical evidence of chorioamnionitis confirmed by placental pathology (group C + P); pathological evidence of chorioamnionitis without clinical signs (group P); clinical signs only (group C); and patients without clinical or pathological findings (group N). Groups were compared to gestational age matched controls.


RESULTS
Forty eight patients recruited, with 28 eligible for analysis: 10 in C + P group, 10 P group, 3 C group, and 5 N group. None of the control or PPROM patients had positive PCT on admission. At delivery, 3 of 10 group C + P and 4 of 10 group P had positive PCT. Maternal serum PCT sensitivity was 50% and specificity 55.6% for diagnosis of pathological chorioamnionitis.


CONCLUSIONS
Maternal serum PCT is not detectable in PPROM patients at admission or in uncomplicated pregnant controls and is a poor predictor for clinical or pathological chorioamnionitis.
a Department of Obstetrics & Gynecology , University of Rochester Medical Center , Rochester , NY , USA.
Loralei L
LL
Thornburg
a Department of Obstetrics & Gynecology , University of Rochester Medical Center , Rochester , NY , USA.
Ruthanne
R
Queenan
a Department of Obstetrics & Gynecology , University of Rochester Medical Center , Rochester , NY , USA.
Brianne
B
Brandt-Griffith
a Department of Obstetrics & Gynecology , University of Rochester Medical Center , Rochester , NY , USA.
Eva K
EK
Pressman
D000328:Adult; D015415:Biomarkers / Q000097:blood; D002116:Calcitonin / Q000097:blood*; D016022:Case-Control Studies; D002821:Chorioamnionitis / Q000097:blood / Q000175:diagnosis*; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000097:blood / Q000175:diagnosis*; D005865:Gestational Age; D006801:Humans; D011247:Pregnancy; D011379:Prognosis; D011498:Protein Precursors / Q000097:blood*; D055815:Young Adult
D015415:Biomarkers; D011498:Protein Precursors; D002116:Calcitonin
Funisitis; infection; pregnancy; preterm delivery; preterm premature rupture of membranes