Department of Obstetrics and Gynaecology, University College Cork, Cork University Maternity Hospital, Cork, Ireland.
John Radliffe Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom.
Sci Rep. 2018 Apr 23;8(1):6372. doi: 10.1038/s41598-018-24569-8.
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.
本研究评估了在接受紧急或选择性剖宫产的女性中，羊水（AF）中的母体 C 反应蛋白（CRP）作为产后感染预测因子的可行性。在 79 例行剖宫产的女性中，在第 0 天和此后的三天（第 3 天）评估了 AF 细菌培养和母血清及 AF 中的 hs-CRP 水平。单变量分析评估了临床和人口统计学特征，而 ROC 曲线评估了 hs-CRP 作为剖宫产妇女炎症标志物的可行性。在无菌 AF 与 AF 细菌生长的女性中，AF、第 0 天和第 3 天血清 hs-CRP 水平无差异。在 AF 培养阳性的女性中，与选择性剖宫产相比，行急诊剖宫产的女性 AF 和第 0 天血清 hs-CRP 水平更高（p=0.04 和 p=0.02）。仅在急诊剖宫产中，第 0 天和第 3 天血清 hs-CRP 而不是 AF 具有较好的感染预测值（AUC 0.767；95%CI 0.606-0.928 和 AUC 0.791；95%CI 0.645-0.036）。我们得出结论，AF hs-CRP 不能用于评估剖宫产术后炎症或感染的风险。
