The role and importance of procalcitonin in the diagnosis of subclinical intraamniotic infection and the follow-up of premature rupture of membranes

Objectives: To compare maternal plasma procalcitonin (ProCT) levels of women with preterm premature rupture of membranes and premature rupture of membranes to those of healthy pregnant women and determine the role of procalcitonin in the diagnosis of subclinical intraamniotic infection.Methods: A total of 121 patients; including 32 patients diagnosed with preterm premature rupture of membranes between 24th and 34th weeks of pregnancy (Group 1); between 36th and 41st weeks of pregnancy, 35 patients who had been admitted to hospital with premature rupture of membranes (Group 2); between 24th and 34th weeks of pregnancy, 24 healthy pregnant women (Group 3); and 30 healthy pregnant women between 36th and 41st weeks of pregnancy(Group 4); were included in the study. The mean plasma ProCT levels of the groups were compared. Using C-Reactive Protein (CRP) and white blood cell levels and the presence/absence of histological chorioamnionitis and neonatal infection as reference, the role of ProCT levels in the diagnosis of subclinical intraamniotic infection was evaluated.Results: The mean ProCT value of the patients in Group 1 (0,0863ng/mL) was significantly higher than that of Group 2 and Group 3. In Group 1, the mean ProCT value of the patients diagnosed with histological chorioamnionitis (n=13, % 40.7) was found to be significantly higher than that of the remaining patients in the group. When the cut-off value was set at 0,0536 ng/mL, ProCT?s sensitivity in predicting histological chorioamnionitis was 92.3% while its specificity, positive predictive value and negative predictive value were 68.4%, 66.7% and 92.9%, respectively.Conclusion: ProCT levels were significantly higher in patients with preterm premature rupture of membranes (Group 1) than those of Group 2 and Group 3. It was determined that, in patients with preterm rupture of membranes, the specificity and positive predictive value of ProCT in predicting histological chorioamnionitis were higher, compared to CRP. ProCT levels can be beneficial in determining patients with preterm premature rupture of membranes who require expectant management.Key Words : Procalcitonin, Preterm Premature Rupture of Membranes, Subclinical İntraamniotic İnfection