Preterm Premature Rupture of Membranes and the Value of Serum Ferritin During Pregnancy /Al-Elwyia Teaching Hospital / Baghdad / 2023


  • Zina Salah Najeeb Al-Omer B.Sc. Pharmacy. Master’s degree in clinical laboratory science. Ph Degree of science in pharmacy/ clinical laboratory science at college of pharmacy, University of Baghdad.AL-Elwiyea Maternity Teaching Hospital/ Laboratory Department/ Clinical Biochemistry, and hormones unit /Baghdad AlRusafa Health / Ministry of Health.
  • Zainab Qais Said Al-Sabbagh M. B. Ch. B., C. A. B. M. S. Family medicine. AL-Elwiyea Maternity Teaching Hospital/ Baghdad Al-Russafa Health / Ministry of Health
  • Samir Hameed Wannas M. B. Ch. B., F. I. C. M. S. Hematopathology, AL-Elwiyea Maternity Teaching Hospital/ Laboratory Department/Hematology unit /Baghdad Al-Russafa Health / Ministry of Health.
  • Zaid Wajih Awad Hasan M. B. Ch. B. Iraq - FETP Graduate – High Diploma in Field Epidemiology General Directorate of Public Health. Iraq Ministry of Health


PPROM, Ferritin, Pregnant Women


Background: Premature rupture of the membranes (PROM) is the term used to describe membrane
rupture that occurs before labor begins. Membrane rupture that occurs before 37 weeks of gestation
and before childbirth is referred to as preterm PROM (PPROM). Acute phase reactant ferritin rises in
response to inflammation. The purpose of this study was to look at the usefulness of serum ferritin as
a PPROM marker. This study aimed to investigate the usefulness of serum ferritin as a marker for
Methods: A cross-sectional study was carried out in the department of obstetrics & gynecology of
Al-Elwyia Teaching Hospital for 9 months. This study included 180 pregnant women, they were
divided into three groups: the PPROM group included 60 women presented with PPROM, the
Spontaneous labor group included 60 women presented with spontaneous preterm labor, and the
control group included 60 healthy pregnant women. A structured questionnaire was designed, and it
included age, parity, gravidity, gestational age, obstetrical history, and gynecological and past medical
histories. Venous blood samples of 5 ml were collected in plain tubes from each patient to measure
serum ferritin. ANOVA test with LSD post-hoc test was used to compare the significant difference
between the three groups. Analysis of receiver operating characteristic curves was utilized to forecast
serum ferritin's diagnostic ability in PPROM. Statistical significance was considered whenever the P
value was less than 0.05.
Results: Ferritin levels were significantly different between the three groups. Post hoc multiple
comparisons showed that the PPROM group had significantly higher ferritin levels when compared
with the spontaneous preterm group and the controls, while there was no significant difference in serum
ferritin levels between the spontaneous preterm group and the control group. The optimal cut-off
ferritin level for predicting PPROM was 37.41 ng/ml with sensitivity and specificity of 80.8% and
91.6% respectively, and accuracy of 84.4%.
Conclusions: This study concluded that ferritin levels were significantly raised in the PPROM group
compared with the other two groups. The use of ferritin as a predictor for PPROM is recommended as
it does not require additional instruments when a ferritin kit is available, and the results of the test can
be taken rapidly.


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