Increased levels of interleukin-6 in cervical secretions and assessment of the uterine cervix by transvaginal ultrasonography predict preterm premature rupture of the membranes.
OBJECTIVE
The objective of this study was to investigate the predictive factors of premature rupture of the membranes (preterm PROM).


METHODS
The study was undertaken with cervical secretions collected from 72 consenting singleton pregnant women between 20 and 33 weeks of gestation. The levels of interleukin (IL) 1alpha, IL-1beta, IL-6, IL-8, matrix metalloproteinase (MMP) 1, MMP-2, MMP-9, tissue inhibitors of matrix metalloproteinase (TIMP) 1, TIMP-2, granulocyte elastase, and fetal fibronectin in cervical diluted specimens were measured by immunoassay, and the uterine cervix was assessed by transvaginal ultrasonography. Demographic, obstetric, clinical, neonatal, and laboratory data were analyzed by univariate analysis, multiple logistic regression, and receiver operator characteristic curve analysis.


RESULTS
Preterm PROM occurred in 6 women, and 63 women delivered at term. Multiple logistic regression analysis indicated a significant independent association with preterm PROM for the cervical IL-6 levels and cervical length. The receiver operator characteristic curve analysis revealed that an IL-6 level of >/=240 pg/ml in cervical secretions and a cervical length of </=28 mm had higher diagnostic performance in predicting preterm PROM.


CONCLUSIONS
It is suggested that preterm PROM is associated with increased cervical IL-6 levels and a short cervix.
Kishida
Tatsuro
T
Department of Obstetrics and Gynecology, Hokkaido University School of Medicine, Sapporo, Japan. tatsuro@mail.med.upenn.edu
Yamada
Hideto
H
Furuta
Itsuko
I
Kobayashi
Noriko
N
Hirayama
Emi K
EK
Ebina
Yasuhiko
Y
Sakuragi
Noriaki
N
Fujimoto
Seiichiro
S
D000328:Adult; D002584:Cervix Uteri / Q000000981:diagnostic imaging* / Q000378:metabolism*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D015850:Interleukin-6 / Q000378:metabolism*; D016015:Logistic Models; D007752:Obstetric Labor, Premature / Q000000981:diagnostic imaging* / Q000378:metabolism; D011237:Predictive Value of Tests; D011247:Pregnancy; D018709:Statistics, Nonparametric; D014463:Ultrasonography; D014621:Vagina / Q000000981:diagnostic imaging*
D015850:Interleukin-6