Value of maternal procalcitonin levels for predicting subclinical intra-amniotic infection in preterm premature rupture of membranes

J Obstet Gynaecol Res. 2014 Apr;40(4):954-60. doi: 10.1111/jog.12273. Epub 2013 Dec 10.

Abstract

Aim: To determine whether procalcitonin (ProCT) levels can be used to predict subclinical intra-amniotic infection by comparing maternal plasma levels in preterm premature rupture of membranes (PPROM) and premature rupture of membranes (PROM) at term with the levels in healthy pregnant women.

Methods: The mean plasma ProCT levels of 32 patients with PPROM, 35 patients with PROM at term, 24 healthy women at preterm gestation and 30 healthy women at term were compared. In the PPROM group, the presence or absence of histological chorioamnionitis and neonatal infection were used as a reference to analyze ProCT levels.

Results: The mean ProCT level of patients in the PPROM group was significantly higher than those in the PROM group and healthy controls. Patients in the PPROM group diagnosed with histological chorioamnionitis had significantly higher ProCT levels than those of the remaining patients. At a cut-off of 0.054 ng/mL, the sensitivity and specificity of ProCT to predict histological chorioamnionitis were 92.3% and 68.4%, respectively.

Conclusion: ProCT levels were significantly higher in patients with PPROM, and facilitate identification of those who require expectant management.

Keywords: chorioamnionitis; maternal; membrane rupture; preterm delivery; procalcitonin.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Amniotic Fluid / microbiology*
  • Biomarkers / blood
  • Calcitonin / blood*
  • Calcitonin Gene-Related Peptide
  • Chorioamnionitis / blood
  • Chorioamnionitis / diagnosis
  • Chorioamnionitis / microbiology
  • Chorioamnionitis / physiopathology
  • Early Diagnosis
  • Female
  • Fetal Membranes, Premature Rupture / etiology*
  • Humans
  • Predictive Value of Tests
  • Pregnancy
  • Pregnancy Complications, Infectious / blood
  • Pregnancy Complications, Infectious / diagnosis*
  • Pregnancy Complications, Infectious / microbiology
  • Pregnancy Complications, Infectious / physiopathology
  • Prospective Studies
  • Protein Precursors / blood*
  • Up-Regulation*
  • Young Adult

Substances

  • Biomarkers
  • CALCA protein, human
  • Protein Precursors
  • Calcitonin
  • Calcitonin Gene-Related Peptide