Archives of Gynecology and Obstetrics

, Volume 247, Issue 1, pp 31–37 | Cite as

C-reactive protein in preterm premature rupture of the membranes

  • T. Kurki
  • K. Teramo
  • O. Ylikorkala
  • J. Paavonen


The usefulness of maternal C-reactive protein (CRP) measurements in the diagnosis of chorioamnionitis and puerperal and neonatal infectious morbidity was studied among 147 patients with preterm rupture of the membranes (PROM). Thirty-three patients developed chorioamnionitis, 10 patients developed puerperal endometritis, and 21 newborn infants developed neonatal infections. There was no difference in the highest antepartum CRP between patients with or without chorioamnionitis. The overall test performance for CRP was poor suggesting that elevated antepartum CRP may be misleading in the diagnosis of chorioamnionitis. However, use of serial CRP measurements increases the test performance. The high negative predictive value suggests that CRP is useful in predicting the absence of chorioamnionitis.

Key words

CRP PROM Chorioamnionitis 


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  1. Benirschke K (1961) Examination of the placenta. Obstet Gynecol 18:309–333Google Scholar
  2. Bobitt JR, Hayslip CC, Damato JD (1981) Amniotic fluid infection as determined by transabdominal amniocentesis in patients with intact membranes in premature labor. Am J Obstet Gynecol 140:947–952PubMedGoogle Scholar
  3. Cammu H, Goossens A, Derde MP, Temmerman M, Foulon W, Amy JJ (1989) C-reactive protein in preterm labour: association with outcome of tocolysis and placental histology. Br J Obstet Gynaecol 96:314–319PubMedGoogle Scholar
  4. Dinarello CA (1984) Interleukin-1 and the pathogenesis of the acute-phase response. N Engl J Med 311:1413–1418PubMedCrossRefGoogle Scholar
  5. Dodds WG, Iams JD (1987) Maternal C-reactive protein and preterm labor. J Reprod Med 32:527–530PubMedGoogle Scholar
  6. Ernest JM, Swain M, Block SM, Nelson LH, Hatjis CG, Meis PJ (1987) C-reactive protein: a limited test for managing patients with preterm labor or preterm rupture of membranes? Am J Obstet Gynecol 156:449–454PubMedGoogle Scholar
  7. Evans M, Hajj SN, Dovoe LD, Angermann NS, Moavad AH (1980) C-reactive protein as a predictor of infectious morbidity with premature rupture of membranes. Am J Obstet Gynecol 138:648–652PubMedGoogle Scholar
  8. Fisk NM, Fysh J, Child AG, Gatenby PA, Jeffery H, Bradfield AH (1987) Is C-reactive protein really useful in preterm premature rupture of the membranes? Br J Obstet Gynaecol 94:1158–1164Google Scholar
  9. Gibbs RS, Blanco JD (1982) Premature rupture of the membranes. Obstet Gynecol 60:671–679PubMedGoogle Scholar
  10. Harmoinen A, Hällström O, Grönroos P (1980) Rapid quantitative determination of C-reactive protein using laser-nephelometer. Scand J Clin Lab Invest 40:293–295PubMedGoogle Scholar
  11. Harmoinen A, Perko M, Grönroos P (1981) Rapid quantitative determination of C-reactive protein using LKB 8600 reaction rate analyser. Acta Clin Chim 111:117–120CrossRefGoogle Scholar
  12. Hawrylyshyn P, Bernstein P, Milligan JE, Soldin S, Pollard S, Papsin FR (1983) Premature rupture of membranes: the role of C-reactive protein in the prediction of chorioamnionitis. Am J Obstet Gynecol 147:240–246PubMedGoogle Scholar
  13. Kaplan M (1982) C-reactive protein. Relation to disease and pathologic significance. Ann NY Acad Sci 389:419–422PubMedGoogle Scholar
  14. Ledger W (1989) Infection and premature labor. Am J Perinatol 6:234–236PubMedCrossRefGoogle Scholar
  15. Minkoff H (1983) Prematury: infection as an etiologic factor. Obstet Gynecol 62:137–144PubMedGoogle Scholar
  16. Mortimer G, MacDonald DJ, Smeeth A (1985) A pilot study of the frequency and significance of placental villitis. Br J Obstet Gynaecol 92:629–633PubMedGoogle Scholar
  17. Pepyps MB (1981) C-reactive protein fifty years on. Lancet I:653–657CrossRefGoogle Scholar
  18. Potkul RK, Moawad AH, Ponto KL (1985) The association of subclinical infection with preterm labor; the role of C-reactive protein. Am J Obstet Gynecol 153:642–645PubMedGoogle Scholar
  19. Romem Y, Artal R (1984) C-reactive protein as a predictor for chorioamnionitis in cases of premature rupture of the membranes. Am J Obstet Gynecol 150:546–550PubMedGoogle Scholar
  20. Romem Y, Artal R (1985) C-reactive protein in pregnancy and in the postpartum period. Am J Obstet Gynecol 151:380–383PubMedGoogle Scholar
  21. Romero R, Mazor M (1988) Infection and preterm labor. Clin Obstet Gynecol 31:553–582PubMedGoogle Scholar
  22. Stempel LE (1982) Eenie, meenie, minie, mo … What do the data really show? Am J Obstet Gynecol 144:745–752PubMedGoogle Scholar

Copyright information

© Springer-Verlag 1990

Authors and Affiliations

  • T. Kurki
    • 1
  • K. Teramo
    • 1
  • O. Ylikorkala
    • 1
  • J. Paavonen
    • 1
  1. 1.First and Second Department of Obstetrics and GynaecologyUniversity Central HospitalHelsinkiFinland

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