Maternal Serum C-Reactive Protein in Women with Preterm Prelabor Rupture of Membranes.
<h4>Objective</h4>This study evaluated maternal C-reactive protein (CRP) as a predictor of microbial invasion of the amniotic cavity (MIAC) and histological chorioamnionitis (HCA) in women with preterm prelabor rupture of the membranes (PPROM) before and after 32 weeks of gestation.<h...
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2016-01-01
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| Series: | PLoS ONE |
| Online Access: | https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0150217&type=printable |
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| author | Martin Stepan Teresa Cobo Ivana Musilova Helena Hornychova Bo Jacobsson Marian Kacerovsky Marian Kacerovsky |
| author_facet | Martin Stepan Teresa Cobo Ivana Musilova Helena Hornychova Bo Jacobsson Marian Kacerovsky Marian Kacerovsky |
| author_sort | Martin Stepan |
| collection | DOAJ |
| description | <h4>Objective</h4>This study evaluated maternal C-reactive protein (CRP) as a predictor of microbial invasion of the amniotic cavity (MIAC) and histological chorioamnionitis (HCA) in women with preterm prelabor rupture of the membranes (PPROM) before and after 32 weeks of gestation.<h4>Methods</h4>This study was a prospective observational cohort study of 386 women. Maternal serum CRP concentrations were evaluated, and amniotic fluid samples were obtained via transabdominal amniocentesis at the time of admission. Placentas underwent histopathological examination after delivery. MIAC was defined based on a positive PCR for Ureaplasma species, Mycoplasma hominis and Chlamydia trachomatis and/or positive 16S rRNA gene amplification. HCA was defined based on the Salafia classification.<h4>Results</h4>Maternal CRP was significantly higher in women with MIAC and HCA (median 9.0 mg/l) than in women with HCA alone (median 6.9 mg/l), MIAC alone (median 7.4 mg/l) and without MIAC or HCA (median 4.5 mg/l) (p<0.0001). CRP was a weak predictor of the occurrence of MIAC and HCA before and after 32 weeks of gestation. Only the 95th percentile of CRP and PPROM before 32 weeks exhibited a false-positive rate of 1%, a positive predictive value of 90% and a positive likelihood ratio of 13.2 to predict MIAC and HCA. However, the low sensitivity of 15% limits the clinical utility of this detection.<h4>Conclusion</h4>CRP is a poor predictor of the occurrence of MIAC and HCA, even at early gestational ages. |
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| format | Article |
| id | doaj.art-f84456834e144d9e8805a4c5ff773e43 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2025-03-14T15:32:20Z |
| publishDate | 2016-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-f84456834e144d9e8805a4c5ff773e432025-02-25T05:35:20ZengPublic Library of Science (PLoS)PLoS ONE1932-62032016-01-01113e015021710.1371/journal.pone.0150217Maternal Serum C-Reactive Protein in Women with Preterm Prelabor Rupture of Membranes.Martin StepanTeresa CoboIvana MusilovaHelena HornychovaBo JacobssonMarian KacerovskyMarian Kacerovsky<h4>Objective</h4>This study evaluated maternal C-reactive protein (CRP) as a predictor of microbial invasion of the amniotic cavity (MIAC) and histological chorioamnionitis (HCA) in women with preterm prelabor rupture of the membranes (PPROM) before and after 32 weeks of gestation.<h4>Methods</h4>This study was a prospective observational cohort study of 386 women. Maternal serum CRP concentrations were evaluated, and amniotic fluid samples were obtained via transabdominal amniocentesis at the time of admission. Placentas underwent histopathological examination after delivery. MIAC was defined based on a positive PCR for Ureaplasma species, Mycoplasma hominis and Chlamydia trachomatis and/or positive 16S rRNA gene amplification. HCA was defined based on the Salafia classification.<h4>Results</h4>Maternal CRP was significantly higher in women with MIAC and HCA (median 9.0 mg/l) than in women with HCA alone (median 6.9 mg/l), MIAC alone (median 7.4 mg/l) and without MIAC or HCA (median 4.5 mg/l) (p<0.0001). CRP was a weak predictor of the occurrence of MIAC and HCA before and after 32 weeks of gestation. Only the 95th percentile of CRP and PPROM before 32 weeks exhibited a false-positive rate of 1%, a positive predictive value of 90% and a positive likelihood ratio of 13.2 to predict MIAC and HCA. However, the low sensitivity of 15% limits the clinical utility of this detection.<h4>Conclusion</h4>CRP is a poor predictor of the occurrence of MIAC and HCA, even at early gestational ages.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0150217&type=printable |
| spellingShingle | Martin Stepan Teresa Cobo Ivana Musilova Helena Hornychova Bo Jacobsson Marian Kacerovsky Marian Kacerovsky Maternal Serum C-Reactive Protein in Women with Preterm Prelabor Rupture of Membranes. PLoS ONE |
| title | Maternal Serum C-Reactive Protein in Women with Preterm Prelabor Rupture of Membranes. |
| title_full | Maternal Serum C-Reactive Protein in Women with Preterm Prelabor Rupture of Membranes. |
| title_fullStr | Maternal Serum C-Reactive Protein in Women with Preterm Prelabor Rupture of Membranes. |
| title_full_unstemmed | Maternal Serum C-Reactive Protein in Women with Preterm Prelabor Rupture of Membranes. |
| title_short | Maternal Serum C-Reactive Protein in Women with Preterm Prelabor Rupture of Membranes. |
| title_sort | maternal serum c reactive protein in women with preterm prelabor rupture of membranes |
| url | https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0150217&type=printable |
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