Relationship Between Serum Procalcitonin, C-reactive Protein And Premature Rupture Of Membranes

Objective: Premature rupture of membranes is the rupture of membranesnaturally before labor. Gestational age at least37weeks, premature rupture ofmembranes called the term premature rupture of membranes, dissatisfied withthe37weeks of gestation, premature rupture of membranes called pretermpremature rupture of membranes, and referred to as preterm, preterm often incombination with premature rupture of membranes, it is the important causesof harm to the health of the mother and child. Premature rupture ofmembranes is one of the most common complications of perinatal, it is canserious adverse consequences of maternal, fetal and neonatal. Prematurerupture of membranes can lead to elevated rates of preterm birth, increase thefatality of perinatal child fatality, amniotic infection and postpartum infectionrates were higher. Premature rupture of membranes merge caused by a varietyof factors, among these factors, the most closely relationship is infection.Previous studies have shown, CRP is a kind of non-specific markerssynthesized by the liver in the acute phase of the systemic inflammatoryresponse, the predict of intrauterine infection of C-reactive protein has beenaffirmed, and widely used in clinical to determine whether there is intrauterineinfection in Premature rupture of membranes.Serum procalcitonin (plasma procalcitonin, PCT) is an early diagnosticmarker of the recently discovered bacterial or fungal infection. And the valuein the diagnosis of systemic inflammatory reaction has been affirmed, but sofar its relationship with premature rupture of membranes is still studied little.This study has examined the concentration of maternal serum C-reactiveprotein and serum procalcitonin in the term premature rupture of membranesand preterm premature rupture of membranes, to explore the relationshipbetween serum procalcitonin and premature rupture of membranes, and compare with C-reactive protein, observe whether there is a superiority.Understanding of procalcitonin in premature rupture of membranes infectedwith the value in the diagnosis of the etiology and the value of forecastintra-amniotic infection.Methods: Object of study: Selected80cases of pregnant women givingbirth in ward and giving prenatal care in hospital obstetric outpatient inNovember2011to February2012. Will be divided into three groups,(1) Termpremature rupture of membranes in patients with20cases.(2) Pretermpremature rupture of membranes in patients with20cases. PROM groupaverage age:26±3years old, average gestational age:36.8±4weeks.(3)Normal pregnant women group of40cases, average age:25±3years old,average gestational age:37.2±4weeks. Three groups of primipara are singlebirths, and there were no other complications. Specimen collection: Threegroups of pregnant women were collected venous blood3ml at the time ofprenatal care on an outpatient basis or before given to the treatment afteradmission, all the venous blood were centrifuged10min (1000r/min) thansacrificed the serum, all samples were stored in the-20℃refrigerator, waitingfor determined concentrated. Routine disinfection of all pregnant womendiagnosed with premature rupture of membranes of the vulva, vagina andcervix, pressure the bottom of the palace to extract amniotic fluid3ml withneedleless syringe after expansion of the vagina with a speculum, detect themfractional. Experimental methods: Determine procalcitonin quantitatively withdouble antibody sandwich, Shanghai Jiang Lai Biotechnology Co, Ltd., toprovide procalcitonin (PCT), ELISA kit. C-reactive protein by enzyme-linkedimmunosorbent assay determination. PROM group pregnant women wereexamined of C-reactive protein before the treatment routine of after admission.Check white blood cell count, glucose quantitative determination to predictintra-amniotic infection.Result:1The positive rate of CRP and PCT in preterm premature rupture ofmembranes:60.00﹪(12/20),65.00﹪(13/20). The positive rate of CRP and PCT in term premature rupture ofmembranes:55.00﹪(11/20),60.00﹪(12/20).The positive rate of CRP and PCT in premature rupture of membranes:57.50﹪(23/40),62.50﹪(25/40).The positive rate of CRP and PCT in normal control group:5.00﹪(2/40),2.50﹪(1/40).The positive rate of CRP and PCT in PROM are higher than it in thenormal control group, there was significant difference(P＜0.05).Compare the positive rate of CRP and PCT in term premature rupture ofmembranes with it in preterm premature rupture of membranes, there was nosignificant difference(P＞0.05).2Sensitivity, specificity, positive predictive value and negative predictivevalue of CRP in the diagnosis of amniotic infection:57.69﹪,42.86﹪,65.22﹪,35.29﹪.Sensitivity, specificity, positive predictive value and negative predictivevalue of PCT in the diagnosis of amniotic infection:61.54﹪,35.71﹪,64.00﹪,33.33﹪.Sensitivity, specificity, positive predictive value and negative predictivevalue of simultaneous detection of CRP and PCT in the diagnosis of amnioticinfection:69.23﹪,85.71﹪,90.00﹪,60.00﹪.The sensitivity, specificity, positive predictive value and negativepredictive value of PCT are not higher than it in CRP. Between the two is notideal in the diagnosis of intra-amniotic infection.Simultaneous detection of CRP and PCT in the diagnosis of amnioticinfection are higher than only detect CRP or PCT.Conclusions:1The positive rate of CRP and PCT in premature rupture of membranesare high.2Compare the positive rate of CRP and PCT in term premature ruptureof membranes with it in preterm premature rupture of membranes, there wasno significant difference. 3The sensitivity, specificity, positive predictive value and negativepredictive value of PCT are not higher than it in CRP. It is show that, neitherserum procalcitonin nor C-reactive protein has some advantages in thediagnosis of premature rupture of membranes with intra-amniotic infection.4Joint detection of C-reactive protein and procalcitonin has importantvalue in the diagnosis of premature rupture of membranes mergeintra-amniotic infection.