C-reactive protein concentration in vaginal fluid as a marker for intra-amniotic inflammation/infection in preterm premature rupture of membranes

Shim, Soon Sup; Romero, Roberto; Sohn, Yoo-Kyung; Park, Chan-Wook; Park, Joong Shin; Jun, Jong Kwan; Yoon, Bo Hyun

doi:10.1016/j.ajog.2004.10.268

Cited by 10 publications

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“…The median vaginal fluid CRP concentration was higher in fetuses with funisitis, and the concentration >0.8 ng ml -1 remained a predictor of intraamniotic infection and funisitis. On the other hand, Shim et al 3 had not shown any relationship between vaginal fluid CRP levels after pPROM and congenital neonatal infection development.…”

Section: Discussionmentioning

confidence: 99%

“…It may reflect amniotic fluid, cervical mucus, or vaginal fluid CRP levels. 3 As spontaneous rupture of membranes usually occurs close to the cervical os, we reasoned that immediately after pPROM, vaginal fluid CRP concentrations might reflect those of the amniotic fluid. In 26% of women, serum CRP levels were evaluated more than once.…”

Section: Discussionmentioning

confidence: 99%

“…1 Microbial invasion of the amniotic cavity is present in about 50% of pPROM cases, and neonates from pPROM-affected pregnancies are at higher risk of infection-related morbidity. 2,3 Prompt diagnosis of intraamniotic infection, which usually is subclinical, is necessary for the application of the proper pattern of clinical management. To determine whether the patient has intraamniotic inflammation, and thus should be delivered rather than managed expectantly or even treated with tocolytic agents, is often a critical decision with clinical implications for both mother and fetus.…”

Section: Introductionmentioning

confidence: 99%

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Maternal serum and vaginal fluid C-reactive protein levels do not predict early-onset neonatal infection in preterm premature rupture of membranes

Torbé

Kowalski

2010

J Perinatol

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Objective: The aim of this study was to evaluate the usefulness of maternal serum and vaginal fluid C-reactive protein (CRP) determinations in the prediction of neonatal congenital infection.Study Design: Fifty women between 24 and 36 weeks gestation, complicated by preterm premature rupture of membranes (pPROM), were divided into two groups according to the presence (n ¼ 14) or absence (n ¼ 36) of early-onset newborns' infection.Result: Maternal serum and vaginal fluid CRP concentrations were comparable between both groups. Serum CRP levels X10 and X15 mg l -1 predicted neonatal infection with a sensitivity of 47 and 47%, specificity of 63 and 76%, positive predictive value (PPV) of 38 and 47%, and negative predictive value (NPV) of 72 and 76%, respectively. The cutoff value of vaginal CRP X2.4 mg l -1 predicted infection with a sensitivity of 71%, specificity of 47%, PPV of 34%, and NPV of 81%. Receiver-operating characteristic curve analysis revealed that the predictive performance of CRP was poor.Conclusion: Maternal serum and vaginal fluid CRP determinations after pPROM are of poor predictive value in neonatal early-onset infection prediction.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Maternal serum and vaginal fluid C-reactive protein levels do not predict early-onset neonatal infection in preterm premature rupture of membranes

Torbé

Kowalski

2010

J Perinatol

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“…[10] Some maternal factors such as premature rupture of membranes (PROM), perinatal asphyxia, and other problems not resulting from infection are associated with increased CRP. [11,12] In a neonatal intensive care unit (NICU) population with wide ranging differences in age, CRP was increased in those with a history of PROM, fetal distress, and chorioamnionitis. [11][12][13] The maximum CRP response occurs around 24 hours after onset (day 1).…”

Section: Discussionmentioning

confidence: 99%

Serum Interleukin-6 Levels In Differential Diagnosis Of Sepsis And Transient Tachypnea Of Newborn

Uraş¹,

Karadağ²,

Tonbul³

et al. 2009

TUTFD

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Objectives:The aim of this study was to evaluate the role of serum interleukin-6 (IL-6) levels in the differentiation of neonatal bacterial sepsis and TTN. Patients and Methods:The hospital records of 58 newborns with respiratory distress that were above 35 weeks of gestational age were investigated. Patients were divided into two groups. The infection group consisted of patients with proven sepsis and clinical sepsis and the remaining one was TTN group. Clinical findings and white blood cell count, serum C-reactive protein (CRP), IL-6 levels and the ratio of immature neutrophils to total neutrophils count (I/T) were recorded and were compared between the two groups.Results: Serum CRP and IL-6 levels were found higher than normal limits in both of the groups. However there was no significant difference between them. Duration of respiratory distress was longer and I/T ratio was significantly higher in the infection group than TTN group.Conclusion: I/T ratio and IL-6 may contribute to the early diagnosis of sepsis with respiratory symptoms in newborn but IL-6 alone can not distinguish TTN and sepsis.Key words: Interleukin 6; sepsis; newborn; transient tachypnea.Amaç: Bu çalışmanın amacı yenidoğanlarda serum interlökin 6 düzeyinin bakteriyel sepsis ve yenidoğanın geçici takipnesinin ayrımında rolünün araştı-rılmasıdır. Hastalar ve Yöntemler:Solunum sıkıntısı olan ve gestasyonel yaşı 35 haftadan büyük olan 58 yenidoğan çalışmaya alındı. Hastalar, kanıtlanmış veya klinik sepsisi olanlar ve yenidoğanın geçici takipnesi olanlar olmak üzere iki gruba ayrıldı. Klinik bulgular beyaz küre sayısı, C reaktif protein, serum IL-6 düzeyi, periferik yaymada immature nötrofil sayısının toplam nötrofil sayısına oranı kaydedilerek gruplar arasında karşılaştırıldı. Bulgular:Her iki grupta da serum CRP ve IL-6 düzeyleri normal limitlerden yüksek bulunmasına rağmen iki grup arasında fark yoktu. Solunum sıkıntı-sının süresi ve I/T oranı yenidoğanın geçici takipnesi olan grupta belirgin olarak fazla bulundu.Sonuç: IL-6 ve I/T oranı solunum sıkıntısı olan sepsisli yenidoğanların erken tanısı konusunda katkıda bulunurken IL-6 düzeyi tek başına yenidoğanlarda sepsis ve yenidoğanın geçici takipnesinde kullanı-lamaz.Anahtar sözcükler: İnterlökin 6; sepsis; yenidoğan; yenidoğanın geçici takipnesi.

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“…Moreover, amniocentesis may not be feasible when the volume of amniotic fluid is reduced in PPROM patients, and culture results may not be available for several days, and thus not available for immediate management decisions. Therefore, alternative, non-invasive approaches are required to identify pregnancies at risk of microbial invasion of the amniotic cavity (7,8) Transvaginal ultrasound of the cervix is a well recognized, noninvasive, objective tool for the evaluation of cervical status. Moreover, cervical length as determined by transvaginal ultrasound has emerged as a powerful means of predicting spontaneous preterm delivery in both women with preterm labor and intact membranes, and in women with PPROM (9)(10)(11)(12)(13).…”

Section: Introductionmentioning

confidence: 99%

Cervical length and the risk of microbial invasion of the amniotic cavity in women with preterm premature rupture of membranes

Hong

Park

Noh

et al. 2006

American Journal of Obstetrics and Gynecology

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The aims of this study were to determine whether sonographically measured cervical length is of value in the identification of microbial invasion of the amniotic cavity in women with preterm premature rupture of membranes (PPROM) and to compare its performance with maternal blood C-reactive protein (CRP), white blood cell count (WBC), and amniotic fluid (AF) WBC. This prospective observational study enrolled 50 singleton pregnancies with PPROM. Transvaginal ultrasound for measurement of cervical length was performed and maternal blood was collected for the determination of CRP and WBC at the time of amniocentesis. AF obtained by amniocentesis was cultured and WBC determined. The prevalence of a positive amniotic fluid culture was 26% (13/50). Patients with positive amniotic fluid cultures had a significantly shorter median cervical length and higher median CRP, WBC, and AF WBC than did those with negative cultures. Multiple logistic regression indicated that only cervical length had a significant relationship with the log odds of a positive AF culture. Transvaginal sonographic measurement of cervical length is valuable in the identification of microbial invasion of amniotic cavity in women with PPROM. Cervical length performs better than AF WBC, maternal blood CRP, and WBC in the identification of a positive amniotic fluid culture.

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C-reactive protein concentration in vaginal fluid as a marker for intra-amniotic inflammation/infection in preterm premature rupture of membranes

Cited by 10 publications

References 0 publications

Maternal serum and vaginal fluid C-reactive protein levels do not predict early-onset neonatal infection in preterm premature rupture of membranes

Maternal serum and vaginal fluid C-reactive protein levels do not predict early-onset neonatal infection in preterm premature rupture of membranes

Serum Interleukin-6 Levels In Differential Diagnosis Of Sepsis And Transient Tachypnea Of Newborn

Cervical length and the risk of microbial invasion of the amniotic cavity in women with preterm premature rupture of membranes

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