TY - JOUR
T1 - Maternal serum C-reactive protein level does not change significantly after fetal reduction
T2 - It could be used as an indicator of chorioamnionitis
AU - Chen, Shee Uan
AU - Ko, Tsang Ming
AU - Hwa, Hsiao Lin
AU - Lu, Pei Jen
AU - Ho, Hong Nerng
AU - Yang, Yu Shih
N1 - Funding Information:
This study was supported in part by grant NSC-85-2331-B002-17 from the National Science Council of the Republic of China in Taiwan.
Copyright:
Copyright 2007 Elsevier B.V., All rights reserved.
PY - 2001/8/2
Y1 - 2001/8/2
N2 - 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.
AB - 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.
KW - C-reactive protein
KW - Chorioamnionitis
KW - Fetal reduction
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U2 - 10.1023/A:1016684605522
DO - 10.1023/A:1016684605522
M3 - Article
C2 - 11495410
AN - SCOPUS:0034916880
SN - 1058-0468
VL - 18
SP - 336
EP - 340
JO - Journal of Assisted Reproduction and Genetics
JF - Journal of Assisted Reproduction and Genetics
IS - 6
ER -