Can hsCRP be the sole investigation for predicting the severity and outcome in women with pre‑eclampsia presenting late in pregnancy?
Context: Healthcare facilities in developing countries are over burdened and proper triage of patients requiring attention more than others is needed in every sub speciality of medical sciences in them. Patients with pre-eclampsia require attention to prevent any associated complication.
Aims: The aim of this study was to evaluate whether hsCRP alone or in combination could be used as an indicator of severity and predictor of outcome in women with PE presenting to a healthcare facility late in the third trimester.
Settings and Design: Prospective observational study conducted at a teaching medical college and referral hospital catering primarily to rural, semi urban and tribal population.
Methods and Material: 85 women with PE who reported to the hospital after completed 36 weeks of gestation were included. Patients were divided in three groups. hsCRP, biochemical and hematological investigations were performed for each patient. Results were expressed as median. Independent samples Kruskall Wallis one way ANOVA and Mann Whitney U tests were performed and correlation of hsCRP with other parameters and fetal outcome was examined. Statistical Analysis Used: Kruskall Wallis one way ANOVA and Mann Whitney U tests.
Results: hsCRP was significantly elevated in severe PE as compared to PE without severe features and normal patients. Higher requirement of labour induction and caesarean section was seen in severe PE patients along with higher still births and low baby weight babies. hsCRP had positive correlation with other markers of severity of PE and negative correlation with still births and fetal weight in severe PE patients. However, although raised in every case of severe PE, a wide variation was noted in hsCRP values.
Conclusions: hsCRP alone cannot be recommended as a marker of severity or a predictor of outcome in women presenting late in the third trimester of pregnancy. However, in combination with serum uric acid it can be used for that purpose.
Key words: Diastolic blood pressure; hsCRP; Pre‑eclampsia; serum uric acid; still births