Amniotic fluid C-reactive protein as a predictor of infection in caesarean section: a feasibility study

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Marchocki, Zbigniew
Vinturache, Angela
Collins, Kevin
O'Reilly, Paddy
O'Donoghue, Keelin
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This study evaluated the feasibility of maternal C-reactive protein (CRP) in amniotic fluid (AF) as a predictor of post-partum infection in women who undergo emergency or elective caesarean section (CS). AF bacterial culture and levels of hs-CRP in maternal serum and AF were evaluated in Day 0 and three days thereafter (Day 3) in 79 women undergoing CS. Univariate analyses assessed the clinical and demographic characteristics, whereas the ROC curves assessed the feasibility of hs-CRP as marker of inflammation in women who undergo CS. There was no difference in AF, Day 0, and Day 3 serum hs-CRP levels between women with sterile compared to those with bacterial growth in AF. Among women with positive AF cultures, AF and Day 0 serum hs-CRP levels were higher in women who underwent emergency compared to those who had elective CS (p = 0.04, and p = 0.02 respectively). hs-CRP in Day 0 and Day 3 serum but not in AF has a fair predictor value of infection in emergency CS only (AUC 0.767; 95% CI 0.606-0.928, and AUC 0.791; 95% CI 0.645-0.036, respectively). We conclude that AF hs-CRP is not feasible in assessing the risk of post-cesarean inflammation or infection.
Predictive markers , Pregnancy outcome
Marchocki, Z., Vinturache, A., Collins, K., O’ Reilly, P. and O’Donoghue, K. (2018) 'Amniotic fluid C-reactive protein as a predictor of infection in caesarean section: a feasibility study', Scientific Reports, 8, 6372 (10pp). doi: 10.1038/s41598-018-24569-8