Risk factors and biomarkers of infection after Caesarean section
- VernacularTitle:Кесар мэс заслын дараа халдвар үүсэх эрсдэлт хүчин зүйлс ба биомаркер
- Author:
Narantsatsralt D
1
;
Munkhbilguun A
2
;
Erkhembaatar T
2
;
Lkhagvasuren J
2
;
Naran G
2
Author Information
1. Urguu Maternity Hospital of Ulaanbaatar
2. Mongolian National University of Medical Sciences, Mongolia
- Publication Type:Journal Article
- Keywords:
Inflammation;
procalcitonin;
premature rupture of membranes;
sepsis;
sensitivity
- From:Mongolian Medical Sciences
2019;190(4):8-13
- CountryMongolia
- Language:Mongolian
-
Abstract:
Background:The WHO recommends the ideal rate for cesarean section to be 15% of the total birth, but researchers
are still attracting attention to the fact that in recent years this rate has been steadily increasing, and
risk is not decreasing worldwide. Incidence of postcesarean section inflammation and infection are
8-10 times higher than vaginal birth. The determination of lactate levels in early diagnosis of sepsis is
clinically significant and the higher the lactate level increases the risk of mortality.
Objective:The aim of the study is to improve early detection of inflammation and infection and prevention of
serious complications by using risk factors of postcesarean section inflammation and infection, and
detecting procalcitonin and lactate in maternal blood.
Materials and Methods:This research is conducted between 2015-2017 based at the “Urguu” Maternity Hospital, Obstetric
Clinic of National Center for Maternal and Child Health of Mongolia. Factors affecting postcesarean
section inflammation and infection are calculated based on multifactorial regression analysis.
Procalcitonin was determined by enzyme binding assay while lactate, C-reactive protein, and lactate
dehydrogenase were determined by “E-311” the fully automated analyzer.
Results:According to the results of the study, the probability of inflammatory and infectious complication
is 2.4% when the duration of labor increases by one unit, 34.8% when the risk of amniotic fluid
increases, 14.6% when the pregnancy process become more complicated. Whereas, excessive fetal
weight statistically increases the risk of infection, but its impact is low. The result of the study shows
that the procalcitonin sensitivity was 65%, and the specificity was 96%. Lactate resulted in sensitivity
of 56%, but with only 67% specificity. C-reactive protein had a sensitivity of 65% and a specificity of
96%. Lactate dehydrogenase resulted in sensitivity of 95%, and specificity of 82% in the diagnosis
of sepsis.
Conclusion:Postterm pregnancy, premature rupture of membranes, multifetal pregnancy, prolonged labor,
placenta previa, pyelonephritis, chronic hepatitis, chronic hypertensive disorder, anemia, emergency
cesarean section, preeclampsia are risk factors and it is statistically significant at (P<0.0001). The
biomarkers have a direct correlation to all stages of inflammation and infections, which are important
for the diagnosis.
- Full text:2019-190(4)-8-13.pdf
