C‐reactive protein in uncomplicated parturients delivered by Cesarean section

Keski‐Nisula, Leea; Kirkinen, Pertti; Ollikainen, Marja; Saarikoski, Seppo

doi:10.3109/00016349709024366

Cited by 16 publications

(12 citation statements)

References 13 publications

(3 reference statements)

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“…Most frequently altered analytical values found in our cohort, with the exception of absolute lymphopenia, which has been described in COVID-19, 21,24,25 could be explained by most tests being conducted in the immediate postpartum, thus modifying neutrophil count, 26 fibrinogen levels, 26,27 D-Dimer levels, 26,28 and CRP concentration. 27,29 Regarding maternal prognosis, one patient (3%) succumbed to the illness. Although the patient was young, presence of obesity is a risk factor for mortality.…”

Section: Discussionmentioning

confidence: 99%

Maternal and perinatal outcomes and placental pathologic examination of 29 SARS‐CoV‐2 infected patients in the third trimester of gestation

Santana

Wong

Álvarez-Troncoso

et al. 2021

J of Obstet and Gynaecol

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Aim: On December 31, 2019, an unknown outbreak of pulmonary disease was reported in China. The novel coronavirus SARS-CoV-2 was the etiologic agent of this disease, and responsible of the current pandemic of COVID-19. Accumulated evidence on placental features is based most on case-reports and small case-series, with differing results. Methods: We gathered a cohort of 29 infected pregnant mothers who delivered 32 newborns, and had placentas available for pathologic examination. Placentas were compared with a control group. Results: Of the 29 mothers, clinical and radiological features were similar to what was already described in COVID-19. Pregnancy modified some analytical parameters. One of the mothers succumbed to the disease. Of the 32 newborns, 1 developed an early infection, with positive reverse-transcriptase polymerase chain reaction (RT-PCR) at 48 h of life, with an initial RT-PCR negative. SARS-CoV-2 presence was assessed on placental tissue with immunohistochemistry and RT-PCR, both were negative. All newborns had good clinical outcomes. No differences in morphological placental findings were found among both groups. Conclusion: Lack of statistically significant differences among case and control groups suggest that placentas from SARS-CoV-2 infected mothers represent a cohort of normal placentas only submitted because of maternal SARS-CoV-2 status. To the best of our knowledge, no irrefutable cases of vertical transmission have been yet described. Other authors have failed to demonstrate presence of viral RNA in placental tissue. Accumulated knowledge suggests that if vertical transmission is possible, it is a rare event.

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Section: Discussionmentioning

confidence: 99%

Maternal and perinatal outcomes and placental pathologic examination of 29 SARS‐CoV‐2 infected patients in the third trimester of gestation

Santana

Wong

Álvarez-Troncoso

et al. 2021

J of Obstet and Gynaecol

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“…Multiple studies have been conducted measuring this analyte during pregnancy with the use of different detection techniques and cut-off values. Some authors have reported an increase in concentration of CRP with labor, delivery and the immediate postpartum period; although the variability of the values used as abnormal makes generalization difficult 24, 25 . Various authors have attempted to associate serum concentrations of this acute phase reactant with adverse pregnancy outcomes.…”

Section: Discussionmentioning

confidence: 99%

Pregnancy-induced changes in immune protection of the genital tract: defining normal

Anderson

Mendez‐Figueroa

Dahlke

et al. 2013

American Journal of Obstetrics and Gynecology

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Introduction Both the state of pregnancy as well as disruption of vaginal flora and immune mediators may increase the risk of human immunodeficiency virus (HIV)-1 acquisition.. The objective of this study was to define immune changes in lower genital and systemic immunity associated with normal pregnancy. Methods Prospective cohort enrolled low risk pregnant and non-pregnant women ages 18 to 35. Pregnant women at < 14 weeks and non-pregnant women in follicular phase of the menstrual cycle were included. Cervical and vaginal fluid was collected. Concentrations of immune mediators were measured using ELISA-based methods or multiplex immunoassay. Samples were inoculated onto various culture media allowing for growth of Lactobacillus spp, G. vaginalis, E.coli, Enterococcus spp, anaerobic gramnegative rods, Candida, S. aureus, Ureaplasma spp, and Mycoplasma hominis. Concentrations of immune mediators and vaginal colonization frequencies were compared between the pregnant and non-pregnant groups. Results Genital tract concentration of IL-1β was higher during pregnancy compared to non-pregnant participants. Serum CRP concentrations were higher in all trimesters of pregnancy. Concentrations of secretory leukocyte protease inhibitor didn’t differ between groups. Lactobacillus was more commonly isolated from vaginal cultures of non-pregnant participants (100% vs. 70.2%, p=0.02). Identification of Candida, G. vaginalis, M. hominis and S. aureus was common and not different between groups. Ureaplasma spp was isolated from over 60% pregnant participants. Conclusions The pro-inflammatory cytokine, IL-1β, as well as the systemic marker of inflammation, CRP, are increased during pregnancy. The impact of these pro-inflammatory changes during pregnancy deserves further study.

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“…During expectant management, serum CRP levels of all mothers were similar, between 0.1 up to 10 mg/l. Serum CRP levels of all mothers rapidly rose immediately after vaginal delivery or Caesarean section up to 20 mg/l [16][17][18] and, thus, masked the reaction to infection.…”

Section: Pmn Blood Counts and Crpmentioning

confidence: 99%

Impaired Whole‐Blood Polymorphonuclear Leukocyte Migration as a Possible Predictive Marker for Infections in Preterm Premature Rupture of Membranes

Glasner

Egger

Winter

2001

Infectious Diseases in Obstetrics and Gynecology

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Objectives: Steroids, used in preterm premature rupture of membranes (pPROM), to reduce the risk of morbidity and mortality of the preterm neonate, impair the maternal polymorphonuclear leukocyte (PMN)-based immune system. In spite of combination with antibiotics, prenatal and postnatal bacterial infections of mother and child are frequent. This pilot study focuses on the influence of steroids in pPROM on maternal PMN functional capacity and subsequent infections. Methods: After opting for expectant management, eight women with pPROM and no signs of infection were treated by steroids (betamethasone 5.7 mg, i.m. every 24 hours, for three days) and antibiotic therapy with either amoxicillin and clavulanic acid, piperacillin or ampicillin i.v. up to delivery. The conventional inflammation parameters of PMN blood count and C-reactive protein (CRP) were measured daily in parallel with PMN migratory capacity towards N-formyl-methionyl-leucyI-phenylalanine stimulation and under blank conditions, estimated by a whole blood membrane filter assay. Results: In all patients PMN migration decreased during the application of steroids. Three patients showed a decrease in PMN migration below critical values and in spite of antibiotic prophylaxis acute pyelonephritis developed 2-6 days later. PMN count and CRP were not predictive of maternal infection. Conclusion: Reduced PMN function, caused by steroid treatment in pPROM, is suggested to be a reason for serious bacterial infections in spite of antibiotic prophylaxis. PMN migration reflects individual PMN defensive capacity.

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C‐reactive protein in uncomplicated parturients delivered by Cesarean section

Cited by 16 publications

References 13 publications

Maternal and perinatal outcomes and placental pathologic examination of 29 SARS‐CoV‐2 infected patients in the third trimester of gestation

Maternal and perinatal outcomes and placental pathologic examination of 29 SARS‐CoV‐2 infected patients in the third trimester of gestation

Pregnancy-induced changes in immune protection of the genital tract: defining normal

Impaired Whole‐Blood Polymorphonuclear Leukocyte Migration as a Possible Predictive Marker for Infections in Preterm Premature Rupture of Membranes

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