Tocolytics were administered in 66 consecutive women in uncomplicated preterm labour with intact fetal membranes (53 singleton and 13 twin pregnancies).
C-reactive protein (CRP), a marker of
infection, was determined daily and used retrospectively to investigate the role of
subclinical infection in preterm labour and to predict the efficacy of
tocolysis and the development of a clinical perinatal
infection. CRP was also determined in 66 women in uncomplicated labour at term (53 singleton and 13 twin pregnancies). The placenta was examined for histological evidence of
infection in all patients who were delivered before 36 weeks (n = 21) and in all women in the control group (n = 66). Elevated CRP levels were more often found in patients who were refractory to
tocolysis, suggesting an underlying infectious morbidity. Placental
infection was found in 62% of the preterm delivery group and in 12% of the control group. There was an association between elevated CRP levels and histological evidence of placental
infection. However, confounding factors such as
urinary tract infections limit the usefulness of the CRP test. Because CRP cannot predict clinical perinatal
infection accurately, its clinical relevance is very limited.