C-reactive protein in vaginal fluid of patients with preterm premature rupture of membranes

Abstract EN

Objective : To assess whether C- reactive protein (CRP) concentration in vaginal amniotic fluid reflect the condition of the intrauterine environment in patients with preterm premature rupture of membranes at 35 weeks of gestation or more.

Methods: Amniotic fluid was obtained in 40 consecutive patients admitted with the diagnosis of PROM at or more 35 weeks by sterile plastic pipette under complete aseptic technique.

CRP was measured in amniotic fluid, maternal blood and in cord blood obtained at delivery.

Intra amniotic infection was defined as positive amniotic fluid for aerobic and anaerobic bacteria.

Results: A significant correlation was found between amniotic fluid CRP concentration and chorioamnionitis (P < 0.001), also there was significant correlation between chorioamnionitis and positive umbilical cord CRP (p < 0.05).

The positive predictive value& negative predictive value of amniotic fluid CRP and serum (maternal & fetal CRP at cut- off value 6 mg / L for detection of charioamnionitis was 92 % & 100 % respectively.

The sensitivity & specificity of AF CRP as a predictor of chorioamnionitis in PROM was 100 % 588.74 % which reflect that AF CRP is a good marker for early detection of chorioamnionitis.

Conclusion: increased vaginal fluid CRP concentration is associated with intra amniotic inflection and funisitis.