Document Detail


C-reactive protein in vaginal fluid of patients with preterm premature rupture of membranes.
MedLine Citation:
PMID:  14616249     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To assess whether C-reactive protein (CRP) concentrations in cervical amniotic fluid reflect the condition of the intrauterine environment in patients with preterm premature rupture of membranes (PROM) before 35 weeks of gestation. METHODS: Amniotic fluid was obtained in 29 consecutive patients admitted with the diagnosis of preterm PROM earlier than 35 weeks of gestation either by amniocentesis or by collecting cervical fluid. CRP was measured in maternal blood, amniotic fluid, vaginal fluid and in cord blood obtained at delivery. Intraamniotic infection was defined as a positive amniotic fluid for aerobic or anaerobic bacteria, or Mycoplasma. The placentas and umbilical cords were examined for the presence of chorioamnionitis and funisitis. RESULTS: A significant correlation was found between vaginal fluid CRP concentrations and both amniotic fluid (r = 0.95, p < 0.001) and umbilical cord levels (r = 0.47, p < 0.05). No correlation was found between maternal blood and vaginal fluid CRP concentrations. The proportion of patients with intraamniotic infection was 37.9% (11/29). The median (range) vaginal fluid CRP concentration was higher in patients with intraamniotic infection than in those with sterile amniotic fluid [901 (0-1354) vs. 507 (0-798) ng/mL, p < 0.001]. The median (range) vaginal fluid CRP concentration was higher in fetuses with (n = 12) than in those without funisitis (n = 17) [901 (598-1354) vs. 487 (0-1115) ng/mL, p < 0.01]. After adjustment for gestational age, vaginal fluid CRP concentration > 800 ng/mL remained a predictor of intraamniotic infection and funisitis. CONCLUSIONS: Increased vaginal fluid CRP concentration is associated with intraamniotic infection and funisitis. As CRP is produced by hepatocytes and does not cross the placenta, its measurement in vaginal fluid might be an additional parameter for the assessment of fetal well-being in patients with premature PROM.
Authors:
Edoardo Di Naro; Fabio Ghezzi; Luigi Raio; Francesco Romano; Michel D Mueller; Jane McDougall; Ettore Cicinelli
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Acta obstetricia et gynecologica Scandinavica     Volume:  82     ISSN:  0001-6349     ISO Abbreviation:  Acta Obstet Gynecol Scand     Publication Date:  2003 Dec 
Date Detail:
Created Date:  2003-11-17     Completed Date:  2004-01-05     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0370343     Medline TA:  Acta Obstet Gynecol Scand     Country:  Denmark    
Other Details:
Languages:  eng     Pagination:  1072-9     Citation Subset:  IM    
Affiliation:
Departments of Obstetrics and Gynecology, University of Bari, Bari, Italy. edoardodinaro@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Amniocentesis
Amniotic Fluid / chemistry*
Biological Markers / analysis
C-Reactive Protein / analysis*
Cohort Studies
Female
Fetal Membranes, Premature Rupture / diagnosis*
Humans
Odds Ratio
Predictive Value of Tests
Pregnancy
Pregnancy Complications, Infectious / diagnosis*
Pregnancy Outcome*
Pregnancy Trimester, Third
Probability
Prognosis
ROC Curve
Retrospective Studies
Sensitivity and Specificity
Statistics, Nonparametric
Vagina
Chemical
Reg. No./Substance:
0/Biological Markers; 9007-41-4/C-Reactive Protein

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