title: The influence of anaesthetic techniques and type of delivery on peripartum serum interleukin-6 concentrations.
abstract: BACKGROUND
  Interleukin-6 is a pleiotropic cytokine with a wide range of physiological activities. It plays an important role in the immuno-neuro-humoral axis during stress and surgery.
  
  
  METHODS
  Serum interleukin-6 in parturients was measured on hospital admission, immediately after birth and 12 and 24 hours later. All parturients had uncomplicated pregnancies, and delivered vaginally without (n = 31) or with (n = 20) epidural analgesia, or underwent Caesarean section under epidural (n = 20) or general (n = 10) anaesthesia.
  
  
  RESULTS
  Serum interleukin-6 assayed immediately following Caesarean section was low, but peaked 12 hours later, irrespective of the anaesthetic technique or other foetomaternal characteristics. Patients who delivered vaginally showed the highest interleukin-6 levels immediately after delivery. These were positively correlated with serum interleukin-6 on admission and duration of labour. Serum interleukin-6 was significantly higher in parturients who had epidural analgesia, and was significantly lower in those receiving intravaginal prostaglandins compared to those without prostaglandins.
  
  
  CONCLUSIONS
  The interleukin-6 response after Caesarean section can be explained by a generalized acute phase response to surgery, with no anaesthetic, maternal or neonatal interference. The rapid increase in peripartum serum interleukin-6 levels after vaginal delivery reflects, in part, cervical ripening or labour, their physiological triggers and psychological or physical stress. Regional anaesthesia, duration of labour and exogenous prostaglandin administration can modulate the peripartum interleukin-6 response and subsequently the physiological effects of this cytokine.
authors.affiliation: Department of Anaesthesia, ZOL, Genk, Belgium.
authors.forename: R F
authors.initials: RF
authors.lastname: De Jongh
authors.forename: E P
authors.initials: EP
authors.lastname: Bosmans
authors.forename: M J
authors.initials: MJ
authors.lastname: Puylaert
authors.forename: W U
authors.initials: WU
authors.lastname: Ombelet
authors.forename: H J
authors.initials: HJ
authors.lastname: Vandeput
authors.forename: R A
authors.initials: RA
authors.lastname: Berghmans
mesh_terms: D000773:Anesthesia, Obstetrical / Q000379:methods*; D002585:Cesarean Section; D005260:Female; D006801:Humans; D015850:Interleukin-6 / Q000097:blood*; D049590:Postpartum Period / Q000097:blood*; D011247:Pregnancy
chemical_list: D015850:Interleukin-6