Bedside assessment of amniotic fluid interleukin-6 in preterm prelabor rupture of membranes

Am J Obstet Gynecol. 2014 Oct;211(4):385.e1-9. doi: 10.1016/j.ajog.2014.03.069. Epub 2014 Apr 3.

Abstract

Objective: The objective of the study was to determine the diagnostic indices and predictive values by bedside assessment of amniotic fluid interleukin-6 (IL-6) concentration in the identification of microbial invasion of the amniotic cavity (MIAC) and/or histological chorioamnionitis (HCA) in patients with preterm prelabor rupture of membranes.

Study design: One hundred twenty-four women with singleton pregnancies were included in this study. The amniotic fluid was sampled by transabdominal amniocentesis at the time of admission. IL-6 concentrations were assessed with an immunoassay.

Results: The presence of MIAC, HCA, or the coexistence of both was associated with higher amniotic fluid concentrations of IL-6 in both a crude and adjusted analysis. The amniotic fluid concentration of IL-6 of 1000 pg/mL was determined to be the best cutoff value for the prediction of MIAC (sensitivity of 50%, specificity of 95%, positive predictive value of 82%, negative predictive value of 81%, and likelihood ratio of 8.4) or both MIAC and HCA (sensitivity of 60%, specificity of 94%, positive predictive value of 75%, negative predictive value of 88%, and likelihood ratio of 9.4).

Conclusion: The bedside assessment of amniotic fluid IL-6 seems to be an easy, rapid, and inexpensive method for the prediction of MIAC or both MIAC and HCA in pregnancies complicated by preterm prelabor rupture of membranes.

Keywords: amniotic fluid; cytokine; histological chorioamnionitis; interleukin-6; microbial invasion of the amniotic fluid.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Amniocentesis*
  • Amniotic Fluid / metabolism*
  • Amniotic Fluid / microbiology
  • Biomarkers / metabolism
  • Chlamydia Infections / diagnosis
  • Chlamydia trachomatis / isolation & purification
  • Chorioamnionitis / diagnosis*
  • Chorioamnionitis / metabolism
  • Female
  • Fetal Membranes, Premature Rupture / metabolism
  • Humans
  • Interleukin-6 / metabolism*
  • Mycoplasma Infections / diagnosis*
  • Mycoplasma hominis / isolation & purification
  • Point-of-Care Systems*
  • Predictive Value of Tests
  • Pregnancy
  • Pregnancy Complications, Infectious / diagnosis*
  • Pregnancy Complications, Infectious / metabolism
  • Prospective Studies
  • Sensitivity and Specificity
  • Ureaplasma Infections / diagnosis
  • Ureaplasma Infections / metabolism
  • Young Adult

Substances

  • Biomarkers
  • Interleukin-6