Correlation between maternal serum C-reactive protein concentrations and the degree of pre-eclampsia.

Introduction: Hypertensive disorders complicating pregnancy are common& form one of the deadly triadalong with hemorrhage and infection that contribute greatly to maternal morbidity & mortality. This disorder complicates about 5-7% of pregnancy worldwide.
Aim of this study was to measure the levels of maternal serum C-reactive protein in pre-eclamptic and eclamptic patients at 28, 32 and 36 weeks of gestation and to find out any possible correlation between these levels and the severity of pre-eclampsia and eclampsia compared with normal values of control group
Methods: The study will be conducted on eighty primigravida at 28, 32, and 36 weeks of gestation attending El-Shatby maternity university hospital. They will be classified equally into the following groups: Group 1: (20 cases) Twenty normal pregnant women their blood pressure recorded as SBP 130 mmHg or less and DBP is 80 mmHg or less. These patients had no proteinuria, taken as a control group .Group 2: (20 cases) Twenty cases with mild pre-eclampsia, their blood pressure recorded as systolic blood pressure (SBP) more than or equal 140 mmHg and less than 160 mmHg. Their diastolic blood pressure (DBP) more than or equal 90 mmHg and less than 110 mmHg together with proteinuria which is 1+ or 2+ developed after 20 weeks of gestation. Group 3: (20 cases) Twenty cases with severe pre-eclampsia, recorded their blood pressure as SBP more than or equal 160 mmHg and DBP greater than or equal 110 mmHg recorded at least two occasions at least six hours apart plus proteinuria which is 3+ or 4+ on urine dipstick. Group 4: (20 cases) Twenty cases with antepartum eclampsia, these are pre-eclamptic patients with eclamptic fits characterized by generalized tonic-clonic convulsions. The cases should fulfill the following criteria: Primigravida, Singleton intrauterine pregnancy and Festational age 28, 32 and 36 weeks. Exclusion criteria: Hypertension, Increased C-reactive protein (infections, inflammatory conditions, malignancy) and Medical disorders (diabetes mellitus, hepatic disorders, renal disorders).Fits should be excluded when patients for group 4 were selected.
Results and conclusions: The serum levels of C-reactive protein were positively correlated with pregnancy duration in pre-eclamptic pregnancy but not in normal pregnancy during the follow up period. As in normal pregnancy, there was a normal drop in the values of C-reactive protein at 32 weeks. The values of C-reactive protein at 28 weeks were 3.19±1.06 mg/L and the levels at 32 weeks were 2.70±1.01 mg/L then the levels raised up again at 36 weeks to be 4.01±1.28 mg/L. This normal drop was lost in pre-eclamptic pregnancy, as there was progressive increase in the values of C-reactive protein longitudinally during 28 weeks, 32 weeks and 36 weeks. The results were positively correlated with the severity of pre-eclampsia as shown in table 7. As C-reactive protein values in mildpre-eclampsia were much higher than values in normal pregnancy.