“EVALUATION OF THE PREDICTIVE ROLE OF C REACTIVE PROTEIN IN MATERNAL OUTCOME OF PRETERM PREMATURE RUPTURE OF MEMBRANES (PPROM)”

Abstract

AIMS AND OBJECTIVE: To evaluate the role of maternal C-reactive protein(CRP) as a predictor of maternal outcomes- chorioamnionitis, Puerperal pyrexia, wound infection, PPH, URTI and UTI in preterm premature rupture of membranes(PPROM). An institutional based prospective case control study was METHODS: conducted in Gauhati Medical College and Hospital from 1st July 2019 to 31st June 2020.This study was conducted on total 280 antenatal women, 140 cases of PPROM (Group I) and 140 cases of normal term pregnancy (Group II) were used as a control. Cases were selected by sampling who fullled the inclusion and exclusion criteria. The data collected in the study was analysed statistically using descriptive statistics and analysis was carried out by Fischer's exact test. Results were tabulated and analysed statistically using SPSS version 21.0. RESULTS: A total of 280 mothers participated in this study which yields 100% response rate. Among the study groups more complications were observed in Cases group (Group I). The most common maternal complications were found to be puerperal pyrexia (6.40%) followed by wound infection (5.00%) in cases group where as in control groups puerperal pyrexia was seen in 3.60% of mothers and wound infection in 2.10% mothers of control group (Group II). Chorioamnionitis was seen only in cases group (Group I) among 4 patients (2.9%) and all of these had CRP>20mg/L. There was no maternal mortality recorded. CRP has sensitivity 100% (95% CI, 85.18% to 100.00%) and specicity 65.81% (95% CI, 56.47% to 74.33%) and PPV 36.51% (95% CI, 30.90% to 42.51%) and NPV 100%. Thus we can utilize CRP as a predictive tool for maternal complications in PPROM mothers. CONCLUSIONS AND RECOMMENDATION: Antenatal diagnosis of preterm PROM by identifying risk factors is an important tool in the management of PPROM. CRP is early and reliable indicator of maternal complications with high sensitivity and high negative predictive value. Maternal serum CRP at admission is the most accurate infectious marker for predicting the maternal outcome that is currently in routine use. It may serve as a noninvasive screening tool to distinguish between women with PPROM who are at high or at low risk for adverse maternal outcome.`