Relation between chorioamnionitis & serum level of white blood cell, C - reactive protein and procalcitonin

Back ground: There are wide spectrum controversies regarding the appropriate medical approach or management for pregnant mother with premature preterm rupture of membranes (PPROM) remote from term. c-reactive protein (CRP) is an acute phase reactive protein in blood plasma and in response to inflammation, infections, its level will rise different type of cells in several organs can secrete procalcitonin in response to stimulation of bacterial infection and inflammation. Methods: In 75 patient with gestational age 24-34 weeks, with PPROM that enrolled in our study, serum level of WBC, CRP, Procalcitonin in first day of admission & last day before the end of pregnancy were measured, the patient were divided in two group: with and without clinical chorioamnionitis. In order to diagnosis definitive chorioamnionitis, placenta of 52Patients (those who were willing) were sent to a certain pathologist for confirmation of diagnosis by pathological & histological aspects. Results: There was a significant relationship between clinical and pathological results of chorioamnionitis (P= 0.000). No significant difference was observed between procalcitonin and chorioamnionitis in the first and last laboratory check. Analysis shows that none of the dependent factors in the first day of admission can predict chorioamnionitis. WBC and PCT, wasnot significantly different between patients with or without chorioamnionitis. Mean±SD of the first and last WBC counts, CRP and PCT were increased in patients with and withoutchorioamnionitis, according to the clinical criteria of categorization. Conclusions: our results show that CRP may be more specific for clinical differential diagnosisof chorioamnionitis than PCT and WBC count

Keywords:

Premature preterm rupture of membranes , chorioamnionitis , procalcitonin