The use of maternal delta neutrophil index for the prediction of chorioamnionitis in very early preterm premature rupture of membraneThe use of maternal delta neutrophil index for the prediction of chorioamnionitis in very early preterm premature rupture of membranes

Objective: In this study, we aimed to assess the use of maternal delta neutrophil index for the prediction of chorioamnionitis in pregnancies complicated with very early preterm premature rupture of membranes, and to compare this index with other routine infection markers. Methods: The files of all patients who admitted to the Obstetrics and Gynecology Clinic of Faculty of Medicine, ‹nönü University, due to preterm premature rupture of membranes between 16 and 24 weeks of gestation between April 1, 2014 and January 1, 2017 and applied expectant management were reviewed retrospectively, and the patients who were eligible for the inclusion criteria were included in the study. Receiver operating characteristic (ROC) curve analysis was used to determine cut-off values of serum leukocyte with chorioamnionitis, C-reactive protein (CRP), procalcitonin and delta neutrophil index (DNI) levels, and sensitivity and specificity values were calculated. In all analyses, 0.05 was considered as the significance level. Results: A total of 73 patients matching with inclusion criteria were identified. While 43 (58.9%) of these patients were diagnosed with chorioamnionitis, no chorioamnionitis was found in 30 (41.1%) patients. While the cut-off value for DNI was 1.0 [area under receiver operating characteristic (AUROC) 0.943, 95% confidence interval (CI) 0.863–0.984, p<0.0001] with 93.02% sensitivity and 93.33% specificity, it was 13.9 (AUROC 0.650 95% CI 0.529– 0.758, p=0.0239) for leukocyte with 51.16% sensitivity and 90% specificity, and 1.34 (AUROC 0.708, 95% CI 0.590–0.808, p= 0.0006) for CRP with 67.44% sensitivity and 76.67% specificity. Conclusion: Delta neutrophil index is an infection marker which may be useful for the prediction of chorioamnionitis during followup in patients who develop very early preterm premature rupture of membranes, can be checked by complete blood count, of which results can be obtained quickly and does not requires additional costs, and the diagnostic performance of the test seems higher than CRP, procalcitonin and leukocyte.