Preterm erken membran rüptürü olan olgularda koryoamniyonit tan›s›nda C-reaktif protein ve prokalsitonin önemi

The importance of C-reactive protein and procalcitonin in the diagnosis of chorioamnionitis in the cases with preterm premature rupture of membranes

Özet

ile klini¤imize yatan hastalardan klinik koryoamniyonit geliflen ve geliflmeyen olgular›n klinik biyokimyasal belirteçlerini karfl›laflt› rmakt›r. Bu amaçla klinik koryoamniyonit tan›s›nda enfeksiyon belirteçlerinin ortalama de¤erlerinin anlaml›l›k düzeyi, duyarl›l›közgüllükleri ve ayr›ca bu belirteçlerin birbirleri ile olan korelasyonlar› araflt›r›ld›. Yöntem: Çal›flmaya Mersin Üniversitesi T›p Fakültesi Kad›n Hastal› klar› ve Do¤um Klini¤ine PEMR ön tan›s› ile yat›r›larak takip ve tedavi edilen 81 tekil gebeli¤i olan olgular al›nd›. Klinik koryoamniyonit geliflen olgular ve geliflmeyen 48 hastan›n de¤erleri karfl›laflt›- r›ld›. Bulgular: Koryoamniyonit tan›s› alan olgular›n do¤um s›ras›ndaki WBC, CRP ve prokalsitonin ortalamas› ve yat›fl s›ras›ndaki prokalsitonin ortalama de¤eri koryoamniyonit tan›s› almayan gruptan anlaml› olarak daha yüksekti. Sonuç: PEMR tan›s› ile takip edilen olgularda hasta yat›fl›ndaki prokalsitonin ve do¤um zaman›ndaki WBC, serum CRP ve prokalsitoninin klinik koryoamniyonit olgular›nda önemli oldu¤u görüldü. Çal›flmam›zdan bu enfeksiyon belirteçlerinin sadece hastan› n yat›fl› s›ras›nda de¤il hasta takibinde de düzenli aral›klarla bak› larak koryoamniyonitin erken tan›s›nda kullan›labilece¤i (özellikle prokalsitonin) sonucuna var›ld›.

Abstract

Objective: Our aim is to compare the clinical biochemical markers of the cases who developed and did not develop clinical chorioamnionitis among those hospitalized in our clinic with the diagnosis of preterm premature rupture of membranes (PPROM). For that purpose, we investigated the significance levels of mean values, sensitivity and specificity levels of the infection markers and also their correlations with each other in the diagnosis of clinical chorioamnionitis. Methods: Eighty-one cases with singleton pregnancy who were hospitalized with the pre-diagnosis of PPROM and followed up and treated in the Clinic of Gynecology and Obstetrics of the Faculty of Medicine at Mersin University were included in the study. The values of 48 cases who developed and did not develop clinical chorioamnionitis were compared. Results: The mean WBC, CRP and procalcitonin values at labor and mean procalcitonin values at hospitalization were significantly higher in the cases diagnosed with chorioamnionitis than the cases without chorioamnionitis diagnosis. Conclusion: We found out that the procalcitonin values at hospitalization and WBC, serum CRP and procalcitonin values at labor in the cases followed up with the diagnosis of PPROM were significant in clinical chorioamnionitis cases. We concluded in our study that these infection markers (procalcitonin in particular) can be used in the early diagnosis of chorioamnionitis by not checking at hospitalization only but also in the follow-ups of the patients regularly.