Acute phase reactants roles in the early diagnosis of preterm prelabour rupture of membranes: A case-control study

Early diagnosis of premature membrane rupture is important to reduce the risk of feto-maternal complications. The aim of this study was to evaluate the role of serum acute phase reactants in the early diagnosis of premature prelabour rupture of membranes (PPROM). In this case-control study, the role of acute phase reactants in the early diagnosis of PPROM was evaluated in 60 pregnant women with PPROM compared to 60 healthy pregnant women. It was found that mean albumin and factor 12 values were lower, while C-reactive protein (CRP), sedimentation, ceruloplasmin, fibrinogen and protein S values were higher in patients with PPROM. In the classification of PPROM, the areas under the curve (AUC) and cutoff values were determined: albumin (AUC = 0.735, cutoff < 36 g/dL), factor 12 (AUC = 0.732, cutoff < 207.4%), CRP (AUC = 0.698, cutoff > 4.3 mg/L), ferritin (AUC = 0.660, cutoff > 10.39 ng/mL), ceruloplasmin (AUC = 0.788, cutoff > 0.44 mg/dL), fibrinogen (AUC = 0.764, cutoff > 3.74 mg/dL), protein S (AUC = 0.656, cutoff > 42%). In the logistic regression analysis to predict the probability of PPROM according to the optimal cutoff values, the risk of PPROM was found to be OR (odds ratio) = 6.69 times higher in patients with albumin < 36 g/dL, OR = 8.5 times higher in patients with ferritin > 10.39 ng/mL, OR = 4.66 times higher in patients with ceruloplasmin > 0.44 mg/dL, OR = 3.19 times higher in patients with fibrinogen > 3.74 mg/dL and OR = 3.64 times higher in patients with protein S > 42%. The sensitivity of the logistic regression model was found to be 88.3% with a specificity of 81.7%. The likelihood ratio (LR)(+) value of the model was 4.82, and LR(-) value was 0.14. In the Fagan nomogram, if the model was positive, the probability of developing PPROM in the patient was calculated as 67.4%, and if the model was negative, the probability of not developing PPROM was calculated as 87.5%. The combined use of acute phase reactants in the early diagnosis of PPROM may be a helpful diagnostic tool in suspected cases.