Evaluation of C - Reactive protein Associated with Histological Evidence of Chorioamnionitis in Preterm Premature Rupture of Membrane

Accurate prediction of chorioamnionitis remains a critical challenge in cases of preterm rupture of membranes and may influence obstetrical management. C-reactive protein (CRP) is a circulating indicator of inflammation whose role of measurement in clinical practice remains unclear. The aim of our study is to investigate the association of C-reactive protein with histological evidences of chorioamnionitis in preterm premature rupture of membranes. This cross sectional study was done on 50 women with gestational age 25 to 34 weeks and preterm premature rupture of membranes from June of 2009 to June of 2010. HS C-reactive protein was measured at the end of pregnancy. In order to detect histological chorioamnionitis, pathological examination was done on placenta after delivery. All the samples were investigated by a pathologist who was unaware of patient’s clinical status and his CRP level. The extent and location of acute inflammation was reported. Data were analyzed by students’ T-test, Mann Whitney, ROC curve, sensitivity indicators and SPSS software version 13. Mean concentration of C-reactive protein in pathologically detected chorioamnionitis was 7.26±5.07 mg/L and in the patients without chorioamnionitis was 5.21±2.98 mg/L. There is no significant correlation between concentrations of C-reactive protein and chorioamnionitis (p= 0.14). Three cut points was selected (8, 10 and 15) with sensitivity and specificity of 0.62, 0.76, 0.25; 0.85, 0.06 and 1, respectively. There is no clear evidence to support the use of C-reactive protein for the early diagnosis of chorioamnionitis.