Abstract: Background: Preterm prelabour rupture of membranes (PPROM) is one of the common obstetric complications linked to significant maternal and fetal morbidity and mortality. In the developing nations like Bangladesh, where the maternal and child mortality rate is still considerably high, early detection of PPROM and understand-ding its etiology is vital for better management and prevention of complications.
Objective: This study was conducted to determine the association of maternal platelet-to-. Lymphocyte ratio (PLR) with preterm prelabour rupture of membranes.
Methodology: This was a case-control study among purposively selected pregnant women matched for age and gestational age attending inpatient department of Obstetrics and Gynecology, ICMH, Matuail, Dhaka from October 2020 to September 2021. A total 60 pregnant women between 18-35 years of age were included in this study in their 28-36 weeks of gestation. Among them 30 diagnosed women with PPROM were considered as the cases and rest of the 30 matched healthy pregnant women without PPROM were selected as controls. After taking consent, and matching eligibility criteria, data were collected from patients on variables of interest using the predesigned semi-structured questionnaire by interview, observation, relevant clinical examination, and laboratory investigation of the participants. Complete blood count in order to investigate platelet- to-lymphocyte ratio, was measured in the laboratory of ICMH, Dhaka. Statistical analysis was done using Microsoft Excel 2010 and the analytic software SPSS v27.0, where required.
Result: The overall PLR level was found significantly higher among the PPROM cases 159.05±49.45 compared to the controls 108.68±18.30 (p<0.001). Considering PLR level of 117.24 as cut-off value, odd's ratio calculation showed PPROM was 5.68 times more likely in pregnant women with elevated PLR level of ≥117.24 than those with < 117.24 (OR=5.68; 95% CI=1.84-17.49, p-value=0.002). The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy rate of PLR was 76.67%, 63.33%, 67.65%, 73.08% and 70.0% respectively.
Conclusions: Raised maternal platelet-to-lymphocyte ratio was found strongly associated with preterm prelabour rupture of membranes.
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