Makkonen M, Suonio S, Saarikoski S
Department of Obstetrics and Gynaecology, Kuopio University Hospital, Finland.
Ann Chir Gynaecol. 1993;82(4):250-3.
Maternal serum C-reactive protein (CRP) values were determined daily during the postpartum period in 113 cases after manual removal of a totally retained placenta. 200 mothers with uncomplicated pregnancy and delivery served as controls. The mean CRP-level in the study group was significantly higher than in the control group on the first postpartum day, 47.17 mg/L (SD 31.62) vs 39.00 mg/L (SD 28.00) and on the second day, 53.06 mg/L (SD 33.95) vs 42.00 mg/L (SD 21.00), reaching similar levels on the third day. The increase of CRP-values on the second day was 12% in the retained placenta group and 7% in the control group. There was no correlation between CRP-values and body temperature, white blood cell count or erythrocyte sedimentation rate, but the CRP-level was lower after excessive blood loss and increased after blood transfusion. Being a marker of infection and tissue damage, the maternal CRP-level on the first and second postpartum day primarily reflects the events of parturition. CRP-levels are higher after manual removal of a totally retained placenta without an obvious explanation for this phenomenon, and this has to be taken into account when CRP is used for diagnosing postpartum infections.
对113例人工剥离完全滞留胎盘的产妇在产后每日测定母血C反应蛋白（CRP）值。选取200例妊娠和分娩均无并发症的产妇作为对照。研究组产后第1天的平均CRP水平显著高于对照组，分别为47.17mg/L（标准差31.62）和39.00mg/L（标准差28.00）；第2天分别为53.06mg/L（标准差33.95）和42.00mg/L（标准差21.00），第3天两组达到相似水平。滞留胎盘组第2天CRP值升高12%，对照组升高7%。CRP值与体温、白细胞计数或红细胞沉降率之间无相关性，但失血过多后CRP水平降低，输血后升高。作为感染和组织损伤的标志物，产后第1天和第2天的母血CRP水平主要反映分娩情况。人工剥离完全滞留胎盘后CRP水平较高，对此现象尚无明确解释，在使用CRP诊断产后感染时必须考虑这一点。
