A STUDY ON PATTERNS OF PLASMA C-REACTIVE PROTEIN LEVELS IN EARLY PREGNANCY AND CONSEQUENT RISK OF PRETERM DELIVERY
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Keywords
Plasma C Reactive Protein,, Preterm Delivery, Early Pregnancy
Abstract
Background: Maternal concentrations of C-reactive protein (CRP) has been studied as an aid in diagnosing subclinical infection in pregnant women who experience preterm labour and premature rupture of membranes. Elevated levels of CRP measured during pregnancy have been linked to adverse pregnancy and neonatal outcomes.
Aim: To study the association of serum C–reactive protein levels in early pregnancy with subsequent preterm delivery and to establish it as a predictive tool for preterm labour.
Methods: Maternal plasma C-reactive protein levels were measured in early pregnancy (< 22 weeks gestation) and were correlated with the time of delivery (preterm/term). A value of 3.6mg/l was taken as cut off for CRP positive or negative. Women were followed up till delivery for the outcome and the values were correlated based on the gestational age at delivery.
Results: Association of CRP levels with preterm delivery was found to be significant. 74.4% patients with CRP levels of > 3.6mg/l had preterm delivery against 14.2% who delivered at term whereas only 25.6% delivered preterm with CRP level <3.6mg/l. CRP levels (>3.6mg/l) had acceptable diagnostic accuracy value in preterm delivery (sensitivity-74.3%, specificity 85.8% , PPV-59.2% , NPV-92.4% and accuracy 83.3%)
Conclusion: The present study demonstrates a positive association between elevated CRP in early pregnancy and the subsequent risk of preterm delivery, which can serve in improving pregnancy management and neonatal outcome.
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Dr Duha Qari
Senior Resident, Department Of Obstetrics And Gynaecology, Skims Maternity Hospital Soura Srinagar
Dr Anjum Malik
Associate Professor, Department Of Obstetrics And Gynaecology, Skims Medical College Hospital Bemina Srinagar
Dr Yousha Muneeb Gillani
Senior Resident, Department Of Anaesthesiology And Critical Care, Government Medical College Srinagar, House No. 5 Al Hijaz Lane, Opposite Police Post Qamarwari, Srinagar, J&K, 190010. Phone No: +917889662580
Dr Ronuma Barooj Qari
Speciality Trainee (Year 1), Royal Derby Hospital
Dr Syed Faheem Maqbool
Junior Speciality Doctor, Higher University Hospital Birmingham