Which maternal blood studies are indicated in the workup of chorioamnionitis?

Updated: May 08, 2018
  • Author: Fayez M Bany-Mohammed, MD; Chief Editor: Ted Rosenkrantz, MD  more...
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Answer

WBC counts or C-reactive protein (CRP) levels in maternal blood have been used to predict acute chorioamnionitis when maternal fever is present. Different studies have supported or refuted the use of CRP to diagnose chorioamnionitis. [178, 179] The CRP level may be a better predictor of the risk of chorioamnionitis than peripheral WBC counts, especially if the mother has received corticosteroids, which may falsely increase the total WBC count.

Other investigators have suggested that the alpha1-proteinase inhibitor (A1PI) complex in maternal blood is a better predictor of amniotic fluid infection than either CRP levels or WBC count. Analysis of maternal serum for either IL-6 or ferritin content may also be helpful, because elevations in these mediators are associated with maternal or neonatal infection. Serum IL-6 levels may be more predictive of infection than CRP concentrations in maternal blood. Levels of A1PI complex, cytokines, and ferritin in maternal blood have not gained widespread use as markers of acute chorioamnionitis.


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