Can maternal serum C-reactive protein levels predict successful labour induction with intravenous oxytocin in term pregnancies complicated with premature rupture of the membranes? A cross-sectional study.
OBJECTIVE
High sensitive C-reactive protein (hs-CRP) is a serum marker for acute inflammation and/or infection. The diagnostic value of serum levels of this protein has been investigated among patients with preterm delivery, premature rupture of the membranes (PROM) and preeclampsia. In this study, the predictive value of hs-CRP for successful labour induction in patients with PROM has been evaluated.


METHODS
Eighty-six term pregnant patients who experienced pre-labour amniotic membrane rupture from 37-41 weeks of gestation were selected for the study. Maternal serum hs-CRP levels were determined upon admission to the delivery unit and low dose intravenous oxytocin infusion was started to induce labour. The mode of delivery and time interval from labour induction to delivery were the primary endpoints of the study.


RESULTS
Twenty-five (29%) out of 86 patients had delivered by caesarean section, while the remaining 61 (71%) had delivered vaginally. The receiver operator characteristic (ROC) curve for testing the significance of higher hs-CRP values and lower probability of vaginal delivery revealed that higher hs-CRP values were found to be insignificant for predicting the need for caesarean section. No statistically significant correlation between high serum hs-CRP levels and the probability of caesarean delivery has been established (Spearman rho:-.126; p=0.24). The mean maternal serum hs-CRP levels during PROM were found to be similar between vaginal and abdominal deliveries.


CONCLUSIONS
Hs-CRP, as an inflammatory marker, was found to be neither specific nor sensitive for the prediction of successful labour induction in term pregnancies with pre-labour rupture of the membranes.
Department of Obstetrics and Gynecology, Dr. Zekai Tahir Burak Women's Health Education and Research Hospital, Ankara, Turkey.
Serkan
S
Kahyaoğlu
Department of Obstetrics and Gynecology, Dr. Zekai Tahir Burak Women's Health Education and Research Hospital, Ankara, Turkey.
Hakan
H
Timur
Department of Obstetrics and Gynecology, Sakarya Maternity Hospital, Sakarya, Turkey.
Remzi
R
Eren
Department of Obstetrics and Gynecology, Etlik Zübeyde Hanım Women's Health Education and Research Hospital, Ankara, Turkey.
Inci
I
Kahyaoğlu
Department of Obstetrics and Gynecology, Dr. Zekai Tahir Burak Women's Health Education and Research Hospital, Ankara, Turkey.
Elif Gül Yapar
EG
Eyi
Department of Obstetrics and Gynecology, Bozok University Faculty of Medicine, Yozgat, Turkey.
Yaprak
Y
Engin-Üstün
C-reactive protein; labour induction; premature rupture of the membranes