Value of Neutrophil Lymphocytic Ratio and Platelet Lymphocytic Ratio in Premature Rupture of Membranes for Detection of Subclinical Chorioamnoitis

Aim: To evaluate neutrophil lymphocytic ratio (N/L) and platelet lymphocytic (P/L) ratio in detection of subclinical Chorioamnoitis in pregnant females suffering from premature rupture of membranes and to compare them with CRP and TLC.

Design: Clinical randomized controlled study.

Methods: 100 pregnant patients were selected suffering from PROM , and prepared for termination of pregnancy either normal or cesarean , all had no clinical signs of chorioamnoitis , blood markers ( CRP, TL, N/L ratio and P/L ratio) were taken before termination , the results statistically analyzed according to the result of pathological examination of amniotic membrane for detection of early inflammatory signs for chorioamnoitis.

Results: There was significant relationship for the P/L ratio and the finding of early chorioamnoitis by pathological examination with P value 0.0004 , however other markers failed to show any significant relationship with early chorioamnoitis , But CRP was found to have a significant relationship with the presence of postpartum complications with P value 0.0003 and other markers had insignificant relationship, There was insignificant relationship with all the four markers with the method of delivery , CRP and TLC had lower specificity in detection of subclinical chorioamnoitis as compared by N/L ratio and P/L ratio , also P/L ratio had the higher sensitivity 85.71% , so by comparing the four markers P/L ratio is the most accurate 90% and N/L ratio had accuracy more than TLC and CRP ( 80%).

Conclusion: P/L ratio and N/L ratio are available cheap markers for detection of subclinical chorioamnoitis, and they show more specificity and accuracy than CRP and TLC in detection of subclinical chorioamnoitis, also P/L ration had higher sensitivity.

Keywords: Subclinical chorioamnoitis, PROM , N/L ratio , P/L ratio , CRP , TLC