Post-delivery, the whole of immune system is restored to normalcy during puerparium. One of the extensively studied immunological markers is the assessment of CA- 125. Spitzer et al15 based on a prospective study reported that, there occurs a steep rise in CA 125 levels during first trimester of pregnancy (mean 43.1 U/mL) and the value is restored to normalcy in subsequent periods. At labor and immediately after the labor, the CA 125 levels rise steeply again (mean 39.9 u/mL) which, is restored to normalcy on day 2. While, it is difficult to interpret the clinical application with the present knowledge, it can be concluded that, puerperal period is also meant to restore immunological status of mother to pre-pregnancy levels.

Besides the above, the role of chronic reactive protein during puerparium, is one of the intriguing factors. In a series of clinical studies, an elevated level of CRP was observed in full term, normal deliveries.

In one of the research studies, a two fold rise in CRP was seen at the onset of labor followed by a ten fold rise on day 3. In general, the CRP levels are seen to come to pre-pregnancy levels by day 11. The CRP touches much higher levels, in case of intervened deliveries like forceps, vacuum extraction.

In Caeserean sections, the rise in CRP is much more marked as result of tissue injury. The rise in CRP is hypothetically attributed to physiological response to hormonal changes. In another study, postnatal flare in polyarthritis was observed due to physiological rise in CRP levels during puerparium. Manual removal of placenta is also associated to high rise in CRP levels due to inflammatory processes involved therein.