Maternal serum C-reactive protein level does not change significantly after fetal reduction: It could be used as an indicator of chorioamnionitis

Purpose: This study was aimed at investigating the diagnostic value of mate rnal serum C-reactive protein (CRP) in the recognition of chorioamnionitis in patients undergoing fetal reduction. Methods: Seventy-one gravidas with high-order multifetal pregnancies, inclu ding 46 with triplets, 18 with quadruplets, and 7 with quintuplets, who und erwent transabdominal fetal reduction Eo twins during the 10th-14th gestati onal week were recruited. The subjects were followed up clinically and ultr aosonographically I week and I month after fetal reduction for signs of inf ection, premature uterine contraction, and premature rupture of the membran es. CRP levels were measured prior to fetal reduction and at follow-up exam inations, and were compared. Results: Among the 71 mothers, 65 (92%) were normal after fetal reduction. The CRP levels were not significantly different prior to rite procedure (0. 27 +/- 0.26 mg/dL), and I week (0.23 +/- 0.24 mg/dL) and I month (0.24 +/- 0.20 mg/dL) Inter: There was no correlation between the number of fetuses r educed and the CRP levels. Six (8%) experienced leakage of amniotic fluid a fter fetal reduction. Three patients had normal CRP levels at that time and at the following tests. The pregnancies continued smoothly after conservat ive treatment. The other three patients had elevated CRP lei els when leaka ge of amniotic fluid occurred. Fever and uterine irritability developed sub sequently despite parenteral antibiotics and tocolytic therapy. Daily check s showed increasing CRP levels. The pregnancies were aborted, and the histo logy of the placental membranes revealed cholioamnionitis with infiltration of acute inflammatory cells. Conclusions: The absorption of inactive gestational tissue after fetal redu ction did Plot affect CRP levels. CRP may he used as a marker of intrauteri ne infection after fetal reduction.