Role of maternal CRP with WBC count in predicting intra-amniotic infection in premature rupture of membranes: a comparative study

Abstract

Aim: To evaluate the usefulness of maternal CRP and WBC count in diagnosing intra-amniontic infection in the preclinical stage in women with prelabor rupture of membranes.

Methods: This prospective observational study was carried out in the Department of Obstetrics and Gynecology at Jawaharlal Nehru Medical College and Hospital, Bhagalpur, Bihar, India from feb 2019 to November 2019. Intra-amniotic infection was confirmed by obtaining amniotic fluid vaginally and subjecting it for aerobic and anaerobic culture.Results: A total of 200 antenatal women were enrolled in the study. The distribution of cases into preterm premature rupture of membranes (PPROM) and premature rupture of membranes (PROM) was 50 each group. 100 gestational age matched controls were equally distributed between PPROM and PROM. Rupture of membranes was more commonly found in women belonging to low socio-economic status in both PPROM and PROM group. In PPROM, 43 cases were positive for maternal CRP while 38 out of 50 were positive in PROM group. 17 PPROM cases out of 50 indicated presence of infection. Among PROM group, 34 cases had maternal WBC count > 15,000 cells/cu.mm. The sensitivity and specificity of maternal CRP was 80.67% and 81.33% respectively. The sensitivity and specificity of WBC count in predicting intra-amniotic infection was 65.66% and 59.84% respectively.

Conclusion: Present study concluded that CRP is a reliable diagnostic marker than WBC count for predicting intra-amniotic infection in pregnancies complicated with rupture of membranes.

Keywords: C-reactive protein, preterm premature rupture of membranes, premature rupture of membranes, white blood cell count