Proadrenomedullin and Serum Amyloid A as a Predictor of Subclinical Chorioamnionitis in Preterm Premature Rupture of Membranes

Çekmez, Yasemin; Çekmez, Ferhat; Özkaya, Enis; Pirgon, Özgür; Yılmaz, Zehra; Yılmaz, Elif; Korkmaz, Vakkaş; Süer, Necdet; Küçüközkan, Tuncay

doi:10.1089/jir.2012.0134

Cited by 13 publications

(18 citation statements)

References 28 publications

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“…In the literature, there were many reports that support the importance of CRP levels in chorioamnionitis patients (11,19,25,26). However, we did not find any difference in the CRP levels and WBC counts between chorioamnionitis (+) and (−) cases in PPROM patients.…”

Section: Chorioamnionitis Chorioamnionitis (+)contrasting

confidence: 79%

Diagnostic and Prognostic Value of Presepsin for Subclinical Chorioamnionitis in Pregnancies between 23-28 Week with Preterm Premature Rupture of the Membranes

Cakar¹,

Çakar²,

Ayvaci³

et al. 2016

Balkan Med J

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Background:Presepsin is an inflammatory marker released from monocytes and macrophages as an acute reaction to microbial infection. We hypothesized that it may be useful in pregnancies with preterm premature rupture of the membranes (PPROM) for early diagnosis of subclinical chorioamnionitis. Aims: To determine whether the plasma presepsin level has any diagnostic or prognostic value for subclinical chorioamnionitis in pregnancies complicated with PPROM. Study Design: Prospective cohort study. Methods: Fifty-three singleton pregnancies between 23 and 28 weeks of gestation diagnosed with PPROM were prospectively included in the study. Venous blood samples were collected at admission, at the 48 th hour of admission, and at the time of delivery to determine presepsin and C-reactive Protein (CRP) levels and white blood cell (WBC) counts. Chorioamnionitis was diagnosed by microscopic examination of the placenta and cords. Results: Of the 53 PPROM cases included in the study, 41 (77.4%) had histologically confirmed chorioamnionitis. Neonatal sepsis developed in 24 (45.3%) of the newborns. The median presepsin level at admission was 135.0 pg/mL for pregnancies with subclinical chorioamnionitis and 113.5pg/mL for pregnancies without chorioamnionitis (p=0.573). There was also no significant difference between subclinical chorioamnionitis (+) and (−) cases in terms presepsin levels at the 48 th hour and at delivery. However, chorioamnionitis (+) cases showed a significant decrease in both presepsin level and WBC count at the 48 th hour after the administration of antibiotics, which increased significantly at delivery (p<0.001 and p=0.011, respectively). Conclusion:The striking fluctuations in presepsin level after the diagnosis of PPROM can be used to predict subclinical chorioamnionitis and determine the optimal timing of delivery before the clinical signs of chorioamnionitis are established. However, presepsin level itself was neither diagnostic nor prognostic for neonatal sepsis. Keywords: Premature rupture of the membranes, preterm, chorioamnionitis, neonatal sepsis

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Section: Chorioamnionitis Chorioamnionitis (+)contrasting

confidence: 79%

Diagnostic and Prognostic Value of Presepsin for Subclinical Chorioamnionitis in Pregnancies between 23-28 Week with Preterm Premature Rupture of the Membranes

Cakar¹,

Çakar²,

Ayvaci³

et al. 2016

Balkan Med J

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“…This receptor has also been identified as being responsible for other activities such as neutrophil IL-8 release or intracellular calcium mobilization (8) . In a previous study, serum proadrenomedullin and SAA levels were reported to be elevated in patients with PPROM and PPROM having subclinical chorioamnionitis (9) .…”

Section: Introductionmentioning

confidence: 85%

“…Few studies investigated association between preterm premature rupture of membranes and serum amyloid A and compare it with other inflammatory markers (9) .…”

Section: Discussionmentioning

confidence: 99%

Maternal Serum Amyloid A Level in Pregnancies Complicated with Preterm Premature Rupture of Membranes

El-Shourbagy

Hemeda

Islam

et al. 2017

EJHM

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Background: serum amyloid A (SAA) is a cytokine-inducible acute-phase reactant whose plasma concentrations can exceed 1 mg/mL during an acute-phase response (500 to 1000 fold of plasma levels greater than in the non inflammatory state) thus representing an ideal marker for clinical use. Preterm premature rupture of membranes (PPROM) complicates only 2% of pregnancies but is associated with 40% of preterm deliveries and can result in significant neonatal morbidity (Prematurity, sepsis and pulmonary hypoplasia) and mortality. Aim of the work: this study aimed to find out association between maternal serum amyloid A level and preterm premature rupture of membranes. Also to compare SAA, CRP levels, N/L ratio in the study group. Patients and methods: this study is a cross sectional study conducted in Ain Shams University Maternity Hospital from December 2015-December 2016 on 58 pregnant women. Women have been allocated in this study, represented in two groups: 1-Study group: including 29 women complaining of preterm premature rupture of membranes. 2-Control group: including 29 women as control group with no complain. Venous blood sample was taken from each participant (study group within 1hour from onset of PPROM, control group during their follow up visit to the clinics). Serum amyloid A, Micro C reactive pretein, total WBCs and neutrophil/lymphocyte ratio (NLR) were calculated. Results: the results point out that PPROM cases had significantly lower GA and APGAR scores at 1 min and more prone to neonatal sepsis which may lead to death. PPROM women have significantly higher total WBC, N/L ratio CRP and serum amyloid A. There were significant positive correlations between amyloid-A, N/L ratio& CRP in both groups. Serum amyloid A level above 2 ng/ml is a risk factor for PPROM and low Apgar score at 1 min. but has low predictive value. CRP with cut off value 5.0 mg/dl has better predictive value in discrimination between PPROM group and control group.Conclusion: Results assessed possible association between maternal SAA, maternal and fetal parameters in pregnancies complicated with PPROM.

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“…It is easy to predict the disease of infants born to mothers who had clinical findings of suspected or overt chorioamnionitis and any other signs of systemic infection, but neonatal sepsis may develop without any kind of maternal infection exist. Subclinical intrauterine infection has been implicated as a major etiological factor in the pathogenesis and subsequent morbidity associated with EOS developed due to preterm membrane rupture, but EOS can also be developed in infants born to mothers who had no risk factor of infection [8].…”

Section: Introductionmentioning

confidence: 99%

The utility of maternal mean platelet volume levels for early onset neonatal sepsis prediction of term infants

Çekmez

Güleçoğlu²,

Özcan³

et al. 2017

Ginekol Pol

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Objectives: This study is aimed to evaluate the role of maternal mean platelet volume (MPV) levels for antenatal prediction marker of early onset neonatal sepsis in term infants born to mothers who have low infection risk. Material and methods:A total of 62 pregnant women who gave birth in our hospital and whose neonates were admitted to a third level Neonatal Intensive Care Unit due to confirmed neonatal sepsis between January 2010 and May 2016 were selected as a study group. Within the same period, 68 women who gave birth to healthy neonates were enrolled as a control group. We compared maternal MPV values which were evaluated before delivery. The receiver operating characteristic (ROC) curves were drawn to evaluate the values maternal MPV in the diagnosis of neonatal sepsis.Results: MPV levels were detected statistically higher in the study group than the control group (8.27 ± 1.85 vs. 8.98 ± 1.16) (p = 0.001). Conclusion:The maternal serum MPV level is a clinically useful, non-invasive and reliable marker in antenatal prediction of EOS.

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Proadrenomedullin and Serum Amyloid A as a Predictor of Subclinical Chorioamnionitis in Preterm Premature Rupture of Membranes

Cited by 13 publications

References 28 publications

Diagnostic and Prognostic Value of Presepsin for Subclinical Chorioamnionitis in Pregnancies between 23-28 Week with Preterm Premature Rupture of the Membranes

Diagnostic and Prognostic Value of Presepsin for Subclinical Chorioamnionitis in Pregnancies between 23-28 Week with Preterm Premature Rupture of the Membranes

Maternal Serum Amyloid A Level in Pregnancies Complicated with Preterm Premature Rupture of Membranes

The utility of maternal mean platelet volume levels for early onset neonatal sepsis prediction of term infants

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