1887
Volume 2024, Issue 1
  • ISSN: 0253-8253
  • EISSN: 2227-0426

Abstract

Background: Pregnancy loss occurring before 20 weeks gestation is referred to as miscarriage. Various clinical presentations of miscarriage include threatened, inevitable, incomplete, complete, septic, and missed miscarriage. Early-stage threatened miscarriage may manifest with symptoms such as abdominal discomfort and vaginal bleeding. Threatened miscarriage is clinically defined as the manifestation of positive fetal heart sounds in pregnancies occurring before the 20th week of gestation, concomitant with vaginal bleeding and a closed cervix.

Objectives: The primary aim of this study was to evaluate the association between serum C-reactive protein (CRP) levels and fetal ultrasound findings in the prediction of threatened miscarriage during the first trimester of pregnancy.

Methods: In this prospective case-control study, a total of 100 pregnant women at 7–13 weeks of gestation were enrolled. All participants initially presented with a singleton embryo displaying cardiac activity on ultrasound. The study cohort was divided into two groups: Group 1 consisted of 50 women with uncomplicated pregnancies, while Group 2 comprised 50 women experiencing symptoms indicative of threatened miscarriage.

Results: Notably, within Group 2, patients who eventually experienced miscarriage exhibited significantly elevated serum high-sensitivity CRP levels in comparison to those who maintained their pregnancies.

Conclusions: Threatened miscarriage cases demonstrated a substantial increase in serum high-sensitivity CRP levels compared to the control group. Furthermore, CRP levels exhibited a correlation with the risk of miscarriage, suggesting their potential utility in conjunction with ultrasound parameters for prognosticating threatened miscarriage during the first trimester.

Loading

Article metrics loading...

/content/journals/10.5339/qmj.2024.9
2024-02-21
2024-11-07
Loading full text...

Full text loading...

/deliver/fulltext/qmj/2024/1/qmj.2024.9.html?itemId=/content/journals/10.5339/qmj.2024.9&mimeType=html&fmt=ahah

References

  1. American College of Obstetricians and Gynecologists’ Committee on Practice Bulletins— Gynecology . ACOG Practice Bulletin No. 200: Early Pregnancy Loss. Obstet Gynecol. 2018 Nov; 132:(5):e197-e207. doi: [Crossref].
    https://doi.org/10.1097/ AOG.0000000000002899 [Google Scholar]
  2. Deutchman M, Tubay AT, Turok D. First trimester bleeding. Am Fam Physician. 2009 Jun 1; 79:(11):985–94.
    [Google Scholar]
  3. Ozdemirci S, Karahanoglu E, Esinler D, Gelisen O, Kayıkcıoglu F. Influence of threatened miscarriage on pregnancy and early postpartum period: a case-control report. J Matern Fetal Neonatal Med. 2015 Jul; 28:(10):1186–9. doi: [Crossref].
    https://doi.org/10.3109/14767058.2014.947577 [Google Scholar]
  4. Akpan UB, Akpanika CJ, Asibong U, Arogundade K, Nwagbata AE, Etuk S. The Influence of Threatened Miscarriage on Pregnancy Outcomes: A Retrospective Cohort Study in a Nigerian Tertiary Hospital. Cureus. 2022 Nov 21; 14:(11):e31734. doi: [Crossref].
    https://doi.org/10.7759/cureus.31734 [Google Scholar]
  5. Magnus MC, Wilcox AJ, Morken NH, Weinberg CR, Håberg SE. Role of maternal age and pregnancy history in risk of miscarriage: prospective register based study. BMJ. 2019 Mar 20; 364:l869. doi: [Crossref].
    https://doi.org/10.1136/bmj.l869 [Google Scholar]
  6. Petriglia G, Palaia I, Musella A, Marchetti C, Antonilli M, Brunelli R, et al.. Threatened abortion and late-pregnancy complications: a case-control study and review of literature. Minerva Ginecol. 2015 Dec; 67:(6):491–7.
    [Google Scholar]
  7. Kashanian M, Aghbali F, Mahali N. Evaluation of the diagnostic value of the first-trimester maternal serum high-sensitivity C-reactive protein level for prediction of pre-eclampsia. J Obstet Gynaecol Res. 2013 Dec; 39:(12):1549–54. doi: [Crossref].
    https://doi.org/10.1111/ jog.12105 [Google Scholar]
  8. Bhattacharya S, Munshi C. Biological significance of C-reactive protein, the ancient acute phase functionary. Front Immunol. 2023 Oct 4; 14:1238411. doi: [Crossref].
    https://doi.org/10.3389/fimmu.2023.1238411 [Google Scholar]
  9. Hermes W, Tamsma JT, Grootendorst DC, Franx A, van der Post J, van Pampus MG, et al.. Cardiovascular risk estimation in women with a history of hypertensive pregnancy disorders at term: a longitudinal follow-up study. BMC Pregnancy Childbirth. 2013 Jun 4; 13:126. doi: [Crossref].
    https://doi.org/10.1186/1471-2393-13-126 [Google Scholar]
  10. Howman RA, Charles AK, Jacques A, Doherty DA, Simmer K, Strunk T, et al.. Inflammatory and haematological markers in the maternal, umbilical cord and infant circulation in histological chorioamnionitis. PLoS One. 2012; 7:(12):e51836. doi: [Crossref].
    https://doi.org/10.1371/journal.pone.0051836 [Google Scholar]
  11. Dal Y. First Trimester Bleeding and Administration. Yilmaz M, Aboalhasan Y, (editors). Current Approaches in Obstetric Hemorrhages. Ankara: Iksad Yayinevi; 2022. p. 77–90.
    [Google Scholar]
  12. Sana Y. Vaginal Bleeding in the First Trimester. Sinha P, editor. A Guide to Problems in Early Pregnancy and Their Management. Cambridge Scholars Publishing; 2022. p. 60.
    [Google Scholar]
  13. Hakeem LA, Bello YO, Obajimi GO, Onifade AFA, Ahmed B, Arowojolu AO, Morhason-Bello IO. Inflammatory cytokines in maternal serum between women with threatened miscarriage and normal pregnancy. Int J Gynaecol Obstet. 2024 Jan; 164:(1):255–261. doi: [Crossref].
    https://doi.org/10.1002/ijgo.15009 [Google Scholar]
  14. Jauniaux E, Gulbis B, Jamil A, Jurkovic D. Evaluation of the role of maternal serum high-sensitivity C-reactive protein in predicting early pregnancy failure. Reprod Biomed Online. 2015 Mar; 30:(3):268–74. doi: [Crossref].
    https://doi.org/10.1016/j.rbmo.2014.11.009 [Google Scholar]
  15. Abdelsamie A, Elsheshtawy R, Abdel Hameed H. Evaluation of the role of maternal serum high sensitivity C-reactive protein correlation with total and differential leucocytic count in predicting outcome in threatened abortion. Fayoum University Medical Journal. 2022; 10:(3):32–39. doi: [Crossref]
    https://doi.org/10.21608/fumj.2022.260462 [Google Scholar]
  16. Cohen Y, Ascher-Landsberg J, Cohen A, Lessing JB, Grisaru D. The role of C-reactive protein measurement as a diagnostic aid in early pregnancy. Eur J Obstet Gynecol Reprod Biol. 2014 May; 176:64–7. doi: [Crossref].
    https://doi.org/10.1016/j.ejogrb.2014.03.004 [Google Scholar]
  17. Nikbakht R, Moghadam EK, Nasirkhani Z. Maternal serum levels of C-reactive protein at early pregnancy to predict fetal growth restriction and preterm delivery: A prospective cohort study. Int J Reprod Biomed. 2020 Mar 29; 18:(3):157–164. doi: [Crossref].
    https://doi.org/10.18502/ijrm.v18i3.6710 [Google Scholar]
  18. Bondarenko N. Evaluation of serum high-sensitivity c-reactive protein levels during various periods of pregnancy in woman, infected with parvovirus-B19 infection. EUREKA: Health Sciences. 2018; 2:3–8. doi: [Crossref]
    https://doi.org/10.21303/2504-5679.2018.00604 [Google Scholar]
  19. Tadmor OP, Achiron R, Rabinowiz R, Aboulafia Y, Mashiach S, Diamant YZ. Predicting first-trimester spontaneous abortion. Ratio of mean sac diameter to crown-rump length compared to embryonic heart rate. J Reprod Med. 1994 Jun; 39:(6):459–62.
    [Google Scholar]
/content/journals/10.5339/qmj.2024.9
Loading
/content/journals/10.5339/qmj.2024.9
Loading

Data & Media loading...

  • Article Type: Research Article
Keyword(s): Egyptfetal ultrasound parametersfirst trimesterreactive protein (CRP) and threatened miscarriage
This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error