The role of C‐reactive protein in modern obstetric and gynecological practice

Abstract

C-reactive protein is an acute phase protein widely used as an indicator of infectious or inflammatory conditions. Traditionally it has been used as an adjunctive test for inflammation and as a marker of disease activity. Though sensitive, its nonspecific nature imposes limitation on its clinical use. Currently C-reactive protein is used in the management of chorioamnionitis, preterm premature rupture of membranes, pelvic inflammatory disease, and urinary tract infection. Interestingly, several obstetric conditions such as pre-eclampsia and gestational diabetes are now known to have an underlying inflammatory basis and there is an emerging role of C-reactive protein testing in managing these diseases. Additionally C-reactive protein testing has an established place in management of several acute abdominal conditions. The aim of this paper is to review the place of C-reactive protein in modern obstetric and gynecological practice.

Periodontal disease severity is related to high levels of C-reactive protein in pre-eclampsia

“…No differences in hs-CRP levels were observed between cases and controls in women with less serious periodontal disease whereas, in those with moderate/severe periodontitis, hs-CRP levels were significantly higher in women who developed pre-eclampsia. The association between chronic periodontal disease and pre-eclampsia [5][6][7][8], and the association between high levels of hs-CRP and preeclampsia [11][12][13][14][15] have been described separately. In the present study, both associations were observed in women with moderate/severe periodontitis.…”

“…It has been proposed that inflammation plays a role in the pathogenesis of cardiovascular disease and adverse pregnancy outcomes [9][10][11][12]. C-reactive protein (CRP) is an acute phase marker of inflammation and an increase in its plasmatic levels is related with tissue damage [9,10].…”

Measuring disease activity and functionality during pregnancy in patients with rheumatoid arthritis

“…In our healthy women the levels measured were slightly higher during pregnancy, but the CRP levels did not increase as pregnancy proceeded. In gynecologists' daily practice, CRP level is already a useful marker of inflammation and infection, and is starting to be used in high-risk obstetrics such as gestational diabetes and preeclampsia (20). The higher CRP level we found during pregnancy agrees nicely with the slightly higher mean CRP levels (0.45 mg/dl) in early pregnancy (4 weeks of gestation) determined in women who became pregnant after in vitro fertilization procedure, and with the lower levels (0.13 mg/dl) in women in whom the procedure had failed (15).…”

Risk Indicators of Pre-Eclampsia in North Jordan: Is Dental Caries Involved?

“…At 0.05 significance level, number of previous pregnancies, interval between pregnancies, blood group, hemoglobin level, consanguinity with partner, total number of antenatal visits, passive smoking, gestational tea and coffee intake, family history of cerebrovascular accidents, and family history of preterm low birth weight deliveries variables were not associated with pre-eclampsia. disease [20] . This suggests that infection could be a common denominator.…”