Publication:

Study of C-reactive protein and procalcitonin in detecting subclinical intrauterine infections in preterm prelabour rupture of membrane

Background Chorioamnionitis or intrauterine infection contributes to approximately 40–50% of preterm deliveries. Clinical signs appear late and are subjective, while conventional investigations such as leukocyte count and cultures are either unreliable or time consuming. Histopathological examination of the placenta confirms the diagnosis only after delivery. This study assessed C-reactive protein (CRP) and procalcitonin (PCT) in detecting subclinical intrauterine infection in women with preterm prelabour rupture of membranes (PPROM).

Methods This cross-sectional study included 40 women with singleton pregnancies complicated by PPROM between 28 and 36+6 weeks of gestation at Hindu Rao Hospital over one year. Women with leaking per vaginum for more than12 hours were enrolled. CRP and PCT levels were measured at admission and delivery. Their association with clinical and histopathological chorioamnionitis was analyzed using SPSS version 25.0, and ROC curves determining optimal cut-off values.

Results The mean age was 25.12±3.7 years, and mean gestational age was 34.98±1.38 weeks. Clinical chorioamnionitis occurred in 80% and histopathological chorioamnionitis in 55% of cases, with risk increasing significantly as leaking duration per vaginum prolonged. CRP was found to be a better predictor than PCT. CRP at termination predicted clinical chorioamnionitis at a cut-off >15.6 mg/l (AUC 0.805), whereas CRP on admission predicted histopathological chorioamnionitis at a cut-off >12 mg/l (AUC 0.941).

Conclusions CRP and PCT are valuable biomarkers for early intrauterine infection detection in PPROM, enabling timely treatment and improving maternal-neonatal outcomes.