Preterm premature rupture of membranes (PPROM) is defined as a spontaneous 
membrane rupture that occurs before the onset of labor and 37 weeks gestation. 
Subclinical intrauterine infection has been suggested as a very important 
etiological factor in the pathogenesis and subsequent morbidity related with 
PPROM. This study was performed to assess the levels of maternal 
proadrenomedullin (pro-ADM) and serum amyloid A (AA) in PPROM and its 
association with fetomaternal infectious morbidity. A total of 63 pregnant 
women, of which 43 with PPROM between 24 and 34 weeks gestation and 20 normal 
pregnant women without PPROM were included in the study. The study group was 
separated into 2 subgroups as PPROM and PPROM-histological chorioamnionitis 
(PPROM-HC). The blood samples were taken before the administration of any 
medication. The mean serum interleukin-6 (IL-6), AA, and pro-ADM values in the 
PPROM-HC group were significantly higher than the PPROM and control group. The 
cutoff values of pro-ADM and AA were determined as 4.2 nM and 69 μg/mL, 
respectively. Both of them showed similar sensitivity, specificity to IL-6 and a 
better sensitivity and specificity as compared to C-reactive protein and white 
blood cell count. We determined the predictive value of pro-ADM and serum AA 
measurements in PPROM and PPROM with histological chorioamnionitis. We suggest 
using pro-ADM and serum AA biomarkers for detecting the histological 
chorioamnionitis at an earlier stage in PPROM without any clinical signs.