1.Risk factors and biomarkers of infection after Caesarean section
Narantsatsralt D ; Munkhbilguun A ; Erkhembaatar T ; Lkhagvasuren J ; Naran G
Mongolian Medical Sciences 2019;190(4):8-13
		                        		
		                        			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.
		                        		
		                        		
		                        		
		                        	
            
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