Document Detail


Maternal serum C-reactive protein level does not change significantly after fetal reduction: it could be used as an indicator of chorioamnionitis.
MedLine Citation:
PMID:  11495410     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: This study was aimed at investigating the diagnostic value of maternal serum C-reactive protein (CRP) in the recognition of chorioamnionitis in patients undergoing fetal reduction.
METHODS: Seventy-one gravidas with high-order multifetal pregnancies, including 46 with triplets, 18 with quadruplets, and 7 with quintuplets, who underwent transabdominal fetal reduction to twins during the 10th-14th gestational week were recruited. The subjects were followed up clinically and ultrasonographically 1 week and 1 month after fetal reduction for signs of infection, premature uterine contraction, and premature rupture of the membranes CRP levels were measured prior to fetal reduction and at follow-up examinations, and were compared.
RESULTS: Among the 71 mothers, 65 (92%) were normal after fetal reduction. The CRP levels were not significantly different prior to the procedure (0.27 +/- 0.26 mg/dL), and 1 week (0.23 +/- 0.24 mg/dL) and 1 month (0.24 +/- 0.20 mg/dL) later. There was no correlation between the number of fetuses reduced and the CRP levels. Six (8%) experienced leakage of amniotic fluid after fetal reduction. Three patients had normal CRP levels at that time and at the following tests. The pregnancies continued smoothly after conservative treatment. The other three patients had elevated CRP levels when leakage of amniotic fluid occurred. Fever and uterine irritability developed subsequently despite parenteral antibiotics and tocolytic therapy. Daily checks showed increasing CRP levels. The pregnancies were aborted, and the histology of the placental membranes revealed chorioamnionitis with infiltration of acute inflammatory cells.
CONCLUSIONS: The absorption of inactive gestational tissue after fetal reduction did not affect CRP levels. CRP may be used as a marker of intrauterine infection after fetal reduction.
Authors:
S U Chen; T M Ko; H L Hwa; P J Lu; H N Ho; Y S Yang
Publication Detail:
Type:  Clinical Trial; Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of assisted reproduction and genetics     Volume:  18     ISSN:  1058-0468     ISO Abbreviation:  J. Assist. Reprod. Genet.     Publication Date:  2001 Jun 
Date Detail:
Created Date:  2001-08-09     Completed Date:  2002-05-07     Revised Date:  2013-02-19    
Medline Journal Info:
Nlm Unique ID:  9206495     Medline TA:  J Assist Reprod Genet     Country:  United States    
Other Details:
Languages:  eng     Pagination:  336-40     Citation Subset:  IM    
Affiliation:
Department of Obstetrics and Gynecology, National Taiwan University Hospital, Taipei.
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MeSH Terms
Descriptor/Qualifier:
C-Reactive Protein / metabolism*
Chorioamnionitis / blood*,  diagnosis*,  pathology
Female
Follow-Up Studies
Gestational Age
Humans
Placenta / pathology
Pregnancy
Pregnancy Reduction, Multifetal*
Pregnancy, Multiple
Chemical
Reg. No./Substance:
9007-41-4/C-Reactive Protein
Comments/Corrections

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