C-REACTIVE PROTEIN IN UNCOMPLICATED PARTURIENTS DELIVERED BY CESAREAN-SECTION

Background. The purpose of this study was to determine normal values a nd evaluate clinical variables associated with postoperative C-reactiv e protein serum concentrations after uncomplicated abdominal delivery. Methods. C-reactive protein serum concentrations were determined seri ally by a quantitative immunoturbidimetric assay in 479 clinically non -infected parturients undergoing uncomplicated Cesarean section, befor e operation and during the first week of puerperium. Associations betw een clinical variables and maximal postoperative C-reactive protein le vels were examined by variance analysis. Results. The preoperative val ues were significantly higher in parturients from whom samples were ob tained after the onset of labor and/or rupture of the membranes (16+/- 10 (s.d.) mg/l) compared with the preoperative values obtained from pa rturients operated with no labor and intact membranes (12+/-7 (s.d.) m g/l) (p<0.0001). An overall significant increase was observed in C-rea ctive protein concentrations after delivery, peaking on the second pos toperative day compared with the preoperative values. In the parturien ts operated upon after the onset of labor or ruptured membranes. posto perative values were 24% higher up to the sixth postoperative day than in parturients operated upon with intact membranes and no labor, The onset of labor, duration of operation. the number of vaginal examinati ons and the duration of internal monitoring before operation were asso ciated with the maximal postoperative C-reactive protein concentration s, but they explained only 9% of postoperative CRP level variation. Co nclusions. The wide range of serum C-reactive protein concentrations d uring puerperium complicates its use as a simple marker in obstetric p ostoperative complications. However, after normal uncomplicated operat ive delivery, C-reactive protein concentrations rapidly decrease towar ds the baseline after the second to third postoperative day.