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PL.45 High-Sensitivity C-Reactive Protein (HS-CRP) in Amniotic Fluid Obtained at Caesarean Section: A Feasibility Study
  1. Z Marchocki1,
  2. K Collins2,
  3. P O’Reilly2,
  4. K O’Donoghue1
  1. 1Department of Obstetrics and Gynaecology, Cork University Maternity Hospital, University College Cork, Cork, Ireland
  2. 2Department of Microbiology, University College Cork, Cork, Ireland

Abstract

Introduction The most important risk factor for post-partum maternal infection is caesarean section (CS). High-sensitivity C-reactive protein (HS-CRP) accurately detects low concentrations of CRP as a predictor of inflammation in blood. This study evaluated the feasibility of measuring HS-CRP in amniotic fluid (AF) and maternal serum at CS.

Methods This was a prospective observational study of women undergoing elective and emergency CS. AF was obtained at CS by direct needle aspiration from intact amnion. Samples were processed for HS-CRP, bacterial count and culture. Maternal serum CRP was measured before and 3 days after CS.

Results Seventy-nine women undergoing CS participated. In 5 (6%), AF could not be analysed; it was either not obtained or could not be processed due to thick meconium. Of the remainder, 47% (35/74) women underwent elective and 53% (39/74) emergency CS. There was a significant difference in AF HS-CRP levels from elective versus emergency CS (median 68.6 ng.ml vs 192.3 ng.ml; p = 0.009). There was no difference in serum HS-CRP levels between elective and emergency CS. Almost 60% (44/74) of AF samples showed bacterial colonisation. There was no difference in AF or serum HS-CRP levels between patients with sterile amniotic fluid compared to those with bacterial colonisation. However serum HS-CRP levels were higher where AF samples at emergency CS showed bacterial growth (p = 0.03).

Conclusion This study proves the feasibility of measuring HS-CRP in <1 ml amniotic fluid in both elective and emergency settings. AF HS-CRP levels were significantly higher in emergency compared to elective CS. However, analysis of HS-CRP was limited by AF consistency.

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