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Vol. 46, No. 2, 1998
Issue release date: August 1998
Gynecol Obstet Invest 1998;46:91–95
(DOI:10.1159/000010009)

Interleukin-6 Concentrations in Cervical Secretions in the Prediction of Intrauterine Infection in Preterm Premature Rupture of the Membranes

Rizzo G. · Capponi A. · Vlachopoulou A. · Angelini E. · Grassi C. · Romanini C.
Fetal Medicine Center, Department of Obstetrics and Gynecology, Università di Roma ‘Tor Vergata’, Rome, Italy

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Abstract

The objective of this study was to determine the value of interleukin-6 (IL-6) in cervical secretion to diagnose microbial invasion of the amniotic cavity in patients with premature rupture of the membranes. Cervical secretions were sampled immediately before amniocentesis in 124 patients with singleton pregnancies and preterm premature rupture of the membranes. Gestational age ranged between 24 and 32 weeks. Amniotic fluid was cultured and IL-6 measured in amniotic fluid and cervical secretions. A total of 33.8% (21/124) of the amniotic fluid cultures had positive results. In cervical secretions the median concentration of IL-6 was 672 pg/ml (range 5–1,250) in the presence of intra-amniotic infection in contrast to 95.5 pg/ml (range 12–640) in women with negative amniotic fluid culture (p ≤0.001). There were no differences between IL-6 concentrations in the cervical secretions of patients with or without obvious leakage of amniotic fluid. A significant relationship was found between IL-6 levels in amniotic fluid and in cervical secretions (ρ = 0.74, p ≤0.001). An IL-6 level in cervical secretions >200 pg/ml had a sensitivity of 78.5%, a specificity of 73.1% and a relative risk of 4.6 for intra-amniotic infection. Receiver-operator characteristics curve analysis showed that IL-6 assay in cervical secretions is comparable to IL-6 assay in amniotic fluid in predicting intra-amniotic infection (p = 0.468).

In conclusion, intra-amniotic infection is associated with increased levels of IL-6 and concentrations in cervical secretions are related to amniotic levels. The measurement of IL-6 in cervical secretions may help to noninvasively identify intra-amniotic infection among pregnancies with preterm premature rupture of membranes.



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References

  1. Garite TJ, Freeman RK: Chorioamnionitis in the preterm-gestation Obstet Gynecol 1982;59:539–545.
  2. Romero R, Mazor M: Infection and preterm labor. Clin Obstet Gynecol 1988;31:553–588.
  3. Romero R, Quintero R, Oyarzun E, King Wu Y, Sabo V, Mazor M, Hobbins JC: Intraamniotic infection and the onset of labor in preterm premature rupture of the membranes. Am J Obstet Gynecol 1988;159:661–666.

    External Resources

  4. Averbuch B, Mazor M, Shoham-Vardi I, Chaim W, Vardi H, Horowitz S, Shuster M: Intra-uterine infection in women with preterm premature rupture of the membranes: Maternal and neonatal characteristics. Eur J Obstet Gynecol Reprod Biol 1995;62:25–29.
  5. Moretti M, Sibai BM: Maternal and perinatal outcome of expectant management of premature rupture of membranes in the midtrimester. Am J Obstet Gynecol 1988;159:390–396.
  6. Carroll SG, Ville Y, Greenough A, Gamsu H, Patel B, Philpott Howard J, Nicolaides KH: Preterm prelabour amniorexis: Intrauterine infection and interval between membrane rupture and delivery. Arch Dis Child 1995;72: F43–F46.
  7. Merenstein GB, Weisman LE: Premature rupture of the membranes: Neonatal consequences. Semin Perinatol 1996;20:375–380.
  8. Cotton DB, Hill LM, Strassner HT, Platt LD, Ledger WJ: Use of amniocentesis in preterm gestation with ruptured membranes. Obstet Gynecol 1984;63:38–48.

    External Resources

  9. Romero R, Yoon BH, Mazor M, Gomez R, Gonzales R, Diamond MP, Baumann P, Araneda H, Kenney JS, Cotton DB, Sehgal P: A comparative study of amniotic fluid glucose, white blood cell count, interleukin-6, and Gram stain in the detection of microbial invasion of the amniotic acvity in patients with preterm premature rupture of membranes. Am J Obstet Gynecol 1993;169: 839–851.
  10. Potter NT, Kosuda L, Bigazzi PE , Fleming AD, Vintzileos AM, Homon C, Salafia CM: Relationship among cytokines (IL-1, TNF and IL-8) and histological markers of acute intrauterine infection. J Matern Fetal Invest 1992;1:142–147.
  11. Hillier SL, Witkins SS, Krohn MA, Watts DH, Kiviat NB, Esenbach DA: The relationship of amniotic fluid cytokines and preterm delivery, amniotic fluid infection, histologic chorioamnionitis, and chorioamnion infection. Obstet Gynecol 1993;81:941–948.
  12. Rizzo G, Capponi A, Rinaldo D, Tedeschi D, Arduini C, Romanini C: Interleukin-6 concentrations in cervical secretions identify microbial invasion of amniotic cavity in patients with preterm labor and intact membranes. Am J Obstet Gynecol 1996;175:812–817.
  13. Mitchell MD, Branch DW, Lundin-Schiller S, Romero RJ, Daynes RA, Dudley DJ: Immunologic aspects of preterm labor. Semin Perinatol 1991;15:210–224.
  14. Gibbs RS, Romero R, Hillier SL, Eschenbach DA, Sweet RL: A review of premature birth and subclinical infection. Am J Obstet Gynecol 1992;166:1515–1528.
  15. Gibbs RS, Blanco JD, St Clair PJ, Castaneda YS: Quantitative bacteriology of amniotic fluid from women with clinical intra-amniotic infection at term. J Invest Dis 1982;145:1–8.
  16. Beazley D, Lewis R: The evaluation of infection and pulmonary maturity in women with premature rupture of membranes. Semin Perinatol 20:409–417;1996.


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