High sensitive C reactive protein as an inflammatory indicator in preeclampsia
Keywords:Blood Pressure, HsCRP, Preeclampsia
Background: Preeclampsia is one of the most serious complications of pregnancy and one of the leading cause of maternal, prenatal morbidity and mortality. The present study was carried out to estimate serum high sensitive C- reactive protein in both mild and severe preeclampsia as an indicator of inflammation and to correlate Hs-CRP with blood pressure.
Methods: A case control study was conducted in the Department of Biochemistry and Department of Obstetrics and Gynecology, MIMER Medical College and Bhausaheb Sardesai Rural Hospital Talegaon Dabhade, Pune. The study group include 50 cases of normal pregnant women, 43 clinically diagnosed cases of mild preeclampsia and 7 cases of severe preeclampsia in second and third trimester of pregnancy. 2 ml venous blood samples was collected from all the study participants for estimation of Hs-CRP by ultra-sensitive immunoturbidometric assay spin react method.
Results: There was signiﬁcant increase in the mean serum Hs-CRP levels in normal pregnant women and mild preeclamptic women (p<0.001). Serum Hs-CRP levels were signiﬁcantly higher in severe preeclamspia than mild preeclamptic women (p<0.001). The degree of inflammation increases as HsCRP rises. Hence, present study shows that HsCRP levels increases as disease progresses from mild to severe condition. Significant positive correlations was found between Hs-CRP and Blood Pressure in preeclampsia.
Conclusions: In preeclampsia there is an exaggeration of systemic inflammatory response that might induce reactive oxygen species which further induces endothelial dysfunction. This leads to clinical symptoms of hypertension and proteinuria in preeclampsia. Early detection might minimise systemic complications and maternal death due to preeclampsia. Hence, HsCRP may be used as an important indicator of severity of preeclampsia.
National Health Portal, India 2016. In. Available at: https://www.nhp.gov.in/disease/gynaecology-and-obstetrics/preeclampsia Accessed 1 June 2015.
Uzan J, Carbonnel M, Piconne O, Asmar R, Ayoubi J. Preeclampsia: Pathophysiology, diagnosis and management. Vasc Health Risk Manag. 2011;7:467-74.
Cunningham FG, Leveno KL, Bloom SL, Hauth JC, Gilstrap III LC, Wenstrom K. Chapter 34: Hypertensive disoders in pregnancy. In: Williams text book of obstetrics. Medical Publishing Division. 22nd ed. New York, 2005: 761-808.
Cunningham FG, Leveno KJ, Bloom SL, Spong CY, Dashe J, Hoffman B. Chapter 40: Hypertensive Disoders. In: Williams text book of Obstetrics. McGraw-Hill Publishers; 24th ed. New York, 2014: 728-779.
Reihane Jannesari EK. Level of High Sensitive C‑reactive Protein and Procalcitonin in Pregnant Women with Mild and Severe Preeclampsia. Adv Biomed Res. 2017;6:140.
Mihu D, Razvan C, Malutan A, Mihaela C. Evaluation of maternal systemic inflammatory response in preeclampsia. Taiwan J Obstet Gynecol. 2015;54(2):160-6.
Qiu C, Luthy DA, Zhang C, Walsh SW, Leisenring WM, Williams MA. A Prospective Study of Maternal Serum C-Reactive Protein Concentrations and Risk of Preeclampsia. AJH. 2004;17(2):154-60.
Taylor RN, Davidge ST, Roberts J. Chapter 9 : Endothelial dysfunction and oxidative stress. In: Chesley’s hypertensive disorders of pregnancy. Elsevier publication; 3rd ed. USA, 2009: 143-167.
Gandevani SB, Alian N, Mogadam L. Association of high sensitivity C-Reactive Protein serum levels in early pregnancy with the severity of preeclampsia and fetal birth weight Association of high-sensitivity C-reactive protein serum levels in early pregnancy with the severity of preeclampisa. J Perinat Med. 2012;40:601-5.
Kahhale S, Francisco RP, Zugaib M. Chapter 44: Endothelial Mechanisms in Preeclampsia. In: Endothelium and Cardiovascular Diseases: Vascular Biology and Clinical Syndromes. 2018: 655-664.
Tillett WS, Francis T. Serological reactions in pneumonia with a nonprotein somatic fraction of pneumococcus. J Exp Med. 1930;52(4):561-71.
Sproston NR, Ashworth JJ. Role of C-Reactive Protein at Sites of inflammation and infection. Front Immunol. 2018;9(April):1-11.
Volanakis JE. Human C-reactive protein: Expression, structure, and function. Mol Immunol. 2001;38(2-3):189-97.
Pepys M, Hirschfield G. C-reactive protein: a critical update. J Clin Invest. 2003;111(12):1850-12.
Dhok, S, Saf S. Role of high sensitivity c – reactive protein in adverse pregnancy outcome. J MGIMS. 2010;15:27-31.
Aruna P, Krishnamma M, Ramalingam K, Naidu JN, Prasad M. Study of high sensitive c-reactive protein in preeclampsia. Int J Clin Biochem Res. 2018;5(2):296-300.
Gandham R, Me S, Dayanand CD, Sheela SR, Kiranmayee P. Neutrophil and Platelet to Lymphocyte Ratio in Prevailing the Oxidative Stress and Its Relation with the Endothelial Dysfunction in Preeclampsia. JKIMSU. 2019;8(4):89-97.
Braekke K, Holthe MR, Harsem NK, Fagerhol MK, Staff AC. Calprotectin, a marker of inflammation, is elevated in the maternal but not in the fetal circulation in preeclampsia. Am J Obstet Gynecol. 2005;193(1):227-33.
Mandal KK, Das A, Devi HL, Singh PNN, Singh PWG. Serum high sensitivity C-reactive Protein as predictor of Preeclampsia. J Dent Med Sci. 2016;15(2):26-31.
Mohaupt MG. C-reactive protein and its role in preeclampsia. Hypertension. 2015;65(2):285-6.
Paternoster DM, Fantinato S, Stella A, Nanhornguè KN, Milani M, Plebani M, et al. C- Reactive Protein in Hypertensive Disorders in Pregnancy. Clin Appl Thromb. 2006;12(3):330-7.
Bargale A, Ganu J, Trivedi D, Nagane N, Mudaraddi R, Sagare A. Serum hsCRP and uric acid as indicator of severity in preeclampsia. Int J Pharma Bio Sci. 2011;2(3):340-5.
Can M, Sancar E, Harma M, Guven B, Mungan G, Acikgoz S. Inflammatory markers in preeclamptic patients. Clin Chem Lab Med. 2011;49(9):1469-72.
Khairy A, Fathey H, Abddallah K, Saber A. C Reactive Protein Level as an Inflammatory Marker in Patients with Preeclampsia. Med J Cairo Univ. 2012;80(1):819-22.