Procalcitonin for prediction of chorioamnionitis in preterm premature rupture of membranes^*

Abstract

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.

• Funisitis
• infection
• pregnancy
• preterm delivery
• preterm premature rupture of membranes

Declaration of interest

This work was made possible a grant from the Mae Stone Goode foundation. None of the authors have any potential conflicts of interest with regard to this manuscript.

Notes

* Prior Presentation: This original research was presented in abstract (poster) form at Society for Maternal Fetal Medicine Annual meeting, San Francisco, CA, 2011.