Infection markers during labor at term

Abstract

Serum levels of C-reactive protein (CRP), white blood cell count (WBC), amniotic fluid white blood cells (Gram staining) and leukocyte esterase (LE) activity were measured serially and prospectively in 30 pregnant women in labor at term. Results were retrospectively compared with amniotic fluid bacterial culture results. Leukocyte esterase activity was measured by the dipstick test (Nephurtest) and an in vitro photometric method. Amniotic fluid samples were collected through an intrauterine transvaginal pressure catheter. The serial CRP and WBC levels from admission to the delivery and CRP levels from delivery to the first post partum day increased statistically significantly. Levels of both markers correlated significantly with duration of labor. Both amniotic white blood cells and leukocyte esterase activity increased during labor. Bacterial colonization of amniotic fluid was not clearly associated with amniotic LE-activity or leukocyte count as determinated by Gram stain. The tests evaluated cannot be regarded as reliable methods in distinguishing intra-amniotic infection during labor and vaginal delivery at term.

Intrapartum Fever at Term

“…However, many studies have doubted the value of CRP in diagnosing intrauterine infection. [39][40][41] Reason for doubt could be the low specificity of CRP, the fluctuating values at different gestational ages, and the correlation with duration of labor. [39][40][41] In preterm neonates, maternal serum IL-6 concentration has shown to be a sensitive and specific marker for chorioamnionitis.…”

“…[39][40][41] Reason for doubt could be the low specificity of CRP, the fluctuating values at different gestational ages, and the correlation with duration of labor. [39][40][41] In preterm neonates, maternal serum IL-6 concentration has shown to be a sensitive and specific marker for chorioamnionitis. 42 In line with this, Smulian et al have shown that histologic chorioamnionitis is associated with higher maternal IL-6 levels in term pregnancies 43 ( Table 2 [A]).…”

Intrauterine bacterial growth at birth and risk of asthma and allergic sensitization among offspring at the age of 15 to 17 years

“…After rupture of the membranes, up to 70% to 90% of amniotic fluid becomes colonized with microbes, even during normal delivery. [1][2][3][4] Intrauterine bacterial infection or inflammation in the gestational tissues is commonly thought to be the cause of the onset of preterm labor, even when the membranes are intact. 5 Several studies have focused on the effect of maternal infections and antibiotic administrations during pregnancy and at delivery on the development of asthma among offspring.…”

Hydration and Acute Confusion in Long-Term Care Residents

“…Leukocyte esterase, present in granulocytic leukocytes, catalyzes and reacts with the reagent to produce a purple color that is detected by the reader. This procedure has been used in clinical research as a screening method for urinary tract infection (Keski-Nisula et al, 1995).…”