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Indian Journal of Obstetrics and Gynecology

Volume  11, Issue 3, July-September 2023, Pages 9-17
 

Original Article

Evaluation of CRP as Predictor of Chorioamnionitis in Premature Rupture of Membranes

Pentala Sai Aparna1, Vaishali Taralekar2, Suchita Dabhadkar3

1 Junior Resident (Jr3), Department of Obstetrics and Gynecology, 2,3Professor, Department of Obstetrics and Gynecology, Bharati Vidyapeeth Hospital and Medical College, Pune 411043, Maharashtra, India.

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DOI: http://dx.doi.org/10.21088/ijog.2321.1636.11323.1

Abstract

Background: Early identification of sepsis is essential as the mother has a risk of chorioamnionitis. C-reactive protein levels are done along with placental histopathology to detect chorioamnionitis. It is one of the most significant causes of high perinatal morbidity and mortality.


Aim and Objective: To determine c-reactive protein levels and placental histopathology in premature rupture of membranes for maternal chorioamnionitis.


Methodology: A prospective study was conducted in a tertiary care university medical college hospital and research center in western Maharashtra. A total of 250 pregnant women were reported per vaginal leak during the study period and CRP levels were sent along with urine culture sensitivity and high vaginal swab, post-delivery the placenta was sent for histopathology and were included in the study analysis.


Results: The histopathology was done in all 250 pregnant women, and chorioamnionitis was evident in 46 pregnant women. This gives the incidence of 18.4% of chorioamnionitis in the study population. The sensitivity for CRP was calculated to be 15.22%, with a specificity of 99.02%, positive and negative predictive values of 77.78% and 83.82%, respectively, with an accuracy of 83.60%.

Conclusion: Normal CRP level has good predictive values to rule out maternal chorioamnionitis. A raised single CRP level has low sensitivity to predict histological chorioamnionitis prior to its clinical expression.


Keywords : Maternal Chorioamnionitis, Premature Rupture of Membranes, PROM, High Vaginal Swab, CRP.
Corresponding Author : Vaishali Taralekar