Evaluation of C-reactive protein (CRP) plasma concentration among women during labour and in early puerperium

Joanna Lebdowicz, Aleksandra Rajewska, Dorota Torbé, Andrzej Torbé

Abstract


Objectives: Calculation and analysis of CRP plasma concentration among women during labour and in the second day of puerperium in various clinical situations
Material and methods: 317 participants about estimated due date (EDD) were included to the study and then divided into four groups:
1. Women with labour onset after previous rupture of membranes and spontaneous vaginal delivery – PROM (n= 97)
2. Women with labour onset at intact membranes and spontaneous vaginal delivery – non -PROM (n= 133)
3. Women who delivered by caesarean section for elective indications – ELCS (n= 58)
4. Women who delivered by caesarean section for emergency indications – EMCS (n= 29)
Venous blood sampling for CRP plasma concentration evaluation was done in the course of labour or strictly before elective caesarean section and then, subsequently, on the second day of puerperium.
Results: In all groups postdelivery CRP plasma level was significantly higher than in the course of labour (p < 0,001). CRP plasma concentration during labour among women who finally delivered vaginally was significantly higher in case of amniotic fluid leakage before the onset of labour, in comparison with this found in women with intact membranes (PROM = 6,30 mg/L vs non-PROM = 2,50 mg/L, p < 0,05).
There was a significant difference between groups who gave birth by caesarean section. CRP level was lower among women who had elective caesarean section (EMCS 6,30 mg/L vs ELCS 4,15 mg/L, p < 0,05).
In our study we found significantly higher puerperal CRP plasma level among women after caesarean section, as well for emergency as for elective indications, than among women after vaginal delivery, independently from ruptured or intact foetal membranes (p < 0.001).
There was no difference in the CRP concentration on the 2nd of puerperium between two groups of women who gave birth vaginally, with or without membranes rupture before labour onset (PROM vs non-PROM, NS), same as between those who had caesarean delivery (ELCS vs EMCS, NS).
Conclusions:
1. The increase of CRP plasma concentration follows the parturition and it is significantly higher after caesarean than after vaginal delivery
2. Intrapartum CRP level is higher among women with amniotic fluid leakage before the onset of labour, than in those with intact foetal membranes, what can suggest the participation of inflammatory response in the labour beginning with membranes rupture
3. CRP concentration on the second day of puerperium is similar in women after elective and emergency caesarean section
4. The assessment of CRP concentration as the only test in early puerperium is not useful for the decision making about antibiotic therapy
5. Because of early discharge of women from the hospital, as well after vaginal as caesarean delivery, the usefulness of CRP concentration assessment in early puerperium decreases progressively

Keywords


acute phase reaction, C-reactive protein, caesarean section, delivery, labour, early puerperium

Full Text:

PDF

References


Koj A. Białka ostrej fazy - po 25 latach. Diagn Lab 2010; 46 (1) : 7-14.

Aziza M.M., Irvine L.M., Coker M., Sanusi F.A.: The role of C-reactive protein in modern obstetric and gynecological practice. Acta Obstet Gynecol Scand. 2006;85(4):394-401.

Urbanowicz W.: Rola wątroby w odpowiedzi ostrej fazy. Borgis - Postępy Nauk Medycznych.2000;1:46-49.

Omem Y, Artal R. C-reactive protein in pregnancy and in the postpartum period. Obstet Gynecol 1985; 151: 380-383.

Adler G, Duchinski T, Jasinska A, Piotrowska U. Fibrinogen Fractions in the Third Trimester of Pregnancy and in Puerperium. Thromb Res 2000; 97: 405-410.

Bolz M, Ohde A, Hohfield J. Is determination of C-reactive protein and haptoglobin in puerperium suitable for further therapeutic decisions? Zentralb Gynakol 1994; 116 (2): 110-114.

De Meeus J.B, Pourrat O, Gombert J, Magnin G. C-reactive protein levels at the onset of labour and at day 3 post-partum in normal pregnancy. Clin Exp Obstet Gynecol 1998; 25 (1-2): 9-11.

Cicarelli L.M, Perroni A.G, Zugaib M, de Albuquerque P.B, Campa A. Maternal and Cord Blood Levels of Serum Amyloid A, C-Reactive Protein, Tumor Necrosis Factor-α, Interleukin-1β, and Interleukin-8 During and After Delivery. Mediators Inflamm 2005; 2: 96-100.

Deballon P.O, Radais F, Facy O, D'Athis P, Masson D, Charles PE, Cheynel N, Favre JP, Rat P. C-reactive protein is an early predictor of septic complications after elective surgery. World J Surg 2010; 34: 808–814.

Chileshe E: Determination of C-Reactive Protein Levels in Blood of Post Caesarean Section Mothers at the University Teaching Hospital, Lusaka. A Dissertation Submitted to the University of Zambia in Partial Fulfillment of the Requirement for the Degree of Master of Science in Biochemistry University of Zambia Lusaka August, 2014.

Baez L.Y., Rodriguez P.M.A., Sánchez D.J.C., Carretero S.P, Martínez A.K., Ferrer P.A., Villoria M.C. C-reactive protein in the diagnosis of postoperative infection in pediatric patients: a prospective observational study of 103 patients. J Pediatr Surg 2011; 46: 1726-1731.

Cole D.S., Watts A, Coombes D.S., Avades T. Clinical Utility of Peri-Operative C - reactive protein testing in General Surgery. Ann Royal Coll Surg Engl 2008; 90: 317–321.

Coulter B. C-Reactive Protein. U.S.A. Protein/Serology Bulletin 2003; 9282: 2-6.

White J, Kelly M, Dunsmuir R. C-reactive protein level after total hip and total knee replacement. J Bone Joint Surg 1998; 80: 909-911.

Chaudhary S.B., Vives M.J., Basra S.K., Reiter M.F. Postoperative Spinal Wound Infections and Postprocedural Diskitis. J Spinal Cord Med 2007; 30: 441–451.

Michel E, Genderen V, Lima A, Geus H, Klijn E, Wijnhoven B, Gommers D, Bommel JV. Serum C-Reactive Protein as a Predictor of Morbidity and Mortality in Intensive Care Unit Patients After Esophagectomy. Ann Thorac Surg 2011; 91: 1775-1779.

Keski-Nisula L, Kirkinen P, Ollikainen P, Saarikoski S. C-reactive protein in uncomplicated parturients delivered by cesarean section. Acta Obstet Gynecol Scand 1997; 76: 862-867.

Wiser A, Sivan E, Dulitzki M, Chayen B, Schiff E, Bar-Chaim A, Simchen MJ. C-reactive protein and the mode of onset of labor in term pregnancies. Acta Obstet Gynecol 2008; 87: 26-30.

Kaapa P, Koistinen E. Maternal and neonatal C-reactive protein after interventions during delivery. Acta Obstet Gynecol Scand 1993; 72:5 43–546.

Erkaya S, Engin- Üstün Y, Aktulay A. Mode of delivery does not effect C - reactive protein and ferritin levels. Acta Medica Mediterr 2014; 30: 477-479.




DOI: http://dx.doi.org/10.5281/zenodo.1345003

Refbacks

  • There are currently no refbacks.




Copyright (c) 2018 © The Author(s)

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

Journal of Education, Health and Sport formerly Journal of Health Sciences

Declaration on the original version.

Editors indicates that the main version of the magazine is to issue a "electronic".

The journal has had 5 points in Ministry of Science and Higher Education parametric evaluation. § 8. 2) and § 12. 1. 2) 22.02.2019.

1223 Journal of Education, Health and Sport eISSN 2391-8306 7

ISSN 2391-8306 formerly ISSN: 1429-9623 / 2300-665X

Archives 2011 - 2014

PBN 2011 - 2014

https://pbn.nauka.gov.pl/sedno-webapp/search?search&searchCategory=WORK&filter.inJournal=36616

POL-index 2011 - 2014

https://pbn.nauka.gov.pl/polindex-webapp/browse/journal/journal-32a319c5-a850-4f44-ba70-1418a6087655

BASE 2011 - 2014

https://www.base-search.net/Search/Results?lookfor=Journal+of+Health+Sciences+%28Radom%29&type=all&oaboost=1&ling=1&name=&thes=&refid=dcrespl&newsearch=1

http://elibrary.ru/contents.asp?titleid=37467

http://journal.rsw.edu.pl/index.php/JHS/issue/archive

Indexed in Bases, Bazy indeksacyjne: ERIH Plus, Worldcat, PBN/POL-Index, ICI Journals Master List, Directory of Open Access Journals (DOAJ), ZBD, Ulrich's periodicals, Google Scholar, Polska Bibliografia Lekarska

US NLM = 101679844

101679844 - NLM Catalog Result - NCBI

https://www.ncbi.nlm.nih.gov/nlmcatalog/101679844

Find a library that holds this journal: http://worldcat.org/issn/23918306

Journal Language(s): English 

PBN Poland

https://pbn.nauka.gov.pl/sedno-webapp/journals/49068

POL-index

https://pbn.nauka.gov.pl/polindex-webapp/browse/journal/journal-c39c8169-88d2-45db-9e7f-d948ce9981c4

BASE

https://www.base-search.net/Search/Results?join=AND&bool0[]=AND&lookfor0[]=2391-8306&type0[]=all&page=11&l=pl&oaboost=1&refid=dcpagepl

Redaction, Publisher and Editorial Office

Instytut Kultury Fizycznej Uniwersytet Kazimierza Wielkiego w Bydgoszczy, Institute of Physical Education Kazimierz Wielki University in Bydgoszcz, Poland 85-091 Bydgoszcz ul. Sportowa 2  www.ukw.edu.pl Copyright by Instytut Kultury Fizycznej UKW w Bydgoszczy http://ojs.ukw.edu.pl/index.php/johs  Open Access ISSN 2391-8306 formerly ISSN: 1429-9623 / 2300-665X

The journal has been approved for inclusion in ERIH PLUS.

The ERIH PLUS listing of the journal is available at https://dbh.nsd.uib.no/publiseringskanaler/erihplus/periodical/info?id=485984

SIC Science citation index (calculated on the basis of TCI and Page Rank) 0

Russian Impact factor 0.16

Indexed in Index Copernicus Journals Master List.

http://journals.indexcopernicus.com/Journal+of+Education+Health+and+Sport,p24782242,3.html

ICV 2018 = 95.95 ICV 2017 = 91.30 ICV 2016 = 84.69 ICV 2015 = 93.34 ICV 2014 = 89.51 Standardized Value: 8.27 ICV 2013: 7.32 ICV 2012: 6.41 ICV 20115.48

The InfoBase Index IBI Factor for the year 2015 is 3.56 in InfoBase Index.com.

Website: www.infobaseindex.com

Universal Impact Factor 1.78 for year 2012. (http://www.uifactor.org/AppliedJournals.aspx)

Indexed in Polish Scholarly Bibliography (PBN) (PBN Polska Bibliografia Naukowa) (https://pbn.nauka.gov.pl/journals/36616)

is a portal of the Polish Ministry of Science and Higher Education, collecting information on publications of Polish scientists and on Polish and foreign scholarly journals. Polish Scholarly Bibliograhpy is a part of POL-on - System of Information on Higher Education. It is operated by the Interdisciplinary Centre for Mathematical and Computational Modelling, University of Warsaw.

Indexed in Russian Sciences Index Российский индекс научного цитирования (РИНЦ) http://elibrary.ru/contents.asp?titleid=37467

Indexed in Arianta Polish scientific and professional electronic journals Aneta Drabek i Arkadiusz Pulikowski

(http://www1.bg.us.edu.pl/bazy/czasopisma/czasop_full.asp?id=3595)