Association of Maternal C-Reactive Protein in Severe Pre-Eclampsia

BACKGROUND Endothelial cell dysfunction and inflammation are considered to have a role in the pathophysiology of pre-eclampsia(1). A generalized activation of circulating leukocytes (characteristic of inflammation) has been found during pre-eclampsia. Moreover, increased concentration of CRP and inflammatory markers has been reported in pre-eclampsia(2). We wanted to determine the serum CRP level in preeclampsia and assess the platelet dysfunction in pre-eclampsia and evaluate its association with severity of the disease. METHODS The study was conducted at a tertiary care centre from November 2015 to August 2017. The study included a total of 200 singleton pregnant patients. After collecting basic demographic data and brief history, detailed clinical examination was carried out, routine investigations along with serum C - reactive protein were done. Results were recorded and maternal and foetal outcomes were noted. RESULTS Among the 200 patients who were included in the study, it was found that majority of them were primigravidae. 88% of the patients showed increase in the C-reactive protein, which also correlated with the severity of the disease. Platelet count showed a decreasing trend with increasing severity of the disease and platelet distribution width showed an increasing trend with the increasing severity of the disease. CONCLUSIONS Serum C-reactive protein concentration increases in pre-eclampsia more than that compared to normal pregnancy. The serum C-reactive protein levels also helps in assessing the severity of the disease and its further prognosis. Further the abnormalities in platelet indices caused due to the disease process in pre-eclampsia is worsened due to thrombocytopenia. The morphological features of platelets as studied by Mean platelet volume and platelet distribution width are not consistent with the severity of the disease.