Markedly elevated levels of inflammatory cytokines in maternal serum and peritoneal washing during arrested labor.
BACKGROUND
The role of inflammatory cytokines in the pathophysiology of arrested labor is currently unknown. We measured levels of inflammatory cytokines in maternal serum and peritoneal washings in arrested first stage of labor to assess the possible involvement of these mediators in this obstetric disorder.


METHODS
This was a prospective, case-control study involving 15 women who underwent cesarean section for arrested cervical dilatation (group I), 15 controls who were operated during active labor for nonreassuring fetal heart-rate tracing (group II) and 15 controls who were operated electively (group III). Blood samples were drawn from all women shortly before the operation. The presence of peritoneal fluid was assessed and peritoneal washings were obtained during the operation. All samples were assayed for the inflammatory cytokines interleukin (IL)-1beta, IL-6, IL-8 and soluble IL-2 receptor (sIL-2R) by solid-phase enzyme-linked immunosorbent assay (ELISA).


RESULTS
All women from group I and one patient (6.7%) from group II had some degree of peritoneal fluid accumulation, while none from group III had any. Serum samples from group I contained significantly higher IL-1beta, IL-6, IL-8 and IL-2R levels than both control groups. Peritoneal washings from group I contained significantly higher IL-1beta, IL-6 and IL-8 but similar IL-2R levels.


CONCLUSIONS
Arrested first stage of labor is associated with peritoneal fluid accumulation and increased levels of inflammatory cytokines in both serum and peritoneal fluids. Inflammatory cytokines may therefore be involved in the pathophysiology of arrested labor.
Abramov
Yoram
Y
Department of Obstetrics and Gynecology, Hadassah Hebrew University Medical Center, Ein-Kerem, Jerusalem, Israel. y-abramov@northwestern.edu
Ezra
Yossef
Y
Elchalal
Uriel
U
Ben-Shachar
Inbar
I
Fasouliotis
Sozos J
SJ
Barak
Vivian
V
D000328:Adult; D001202:Ascitic Fluid / Q000378:metabolism*; D002199:Capillary Permeability / Q000502:physiology; D016022:Case-Control Studies; D002585:Cesarean Section; D005260:Female; D006801:Humans; D007378:Interleukins / Q000097:blood / Q000378:metabolism*; D007747:Labor Stage, First / Q000378:metabolism*; D007744:Obstetric Labor Complications / Q000378:metabolism*; D011247:Pregnancy; D011446:Prospective Studies; D015375:Receptors, Interleukin-2 / Q000097:blood / Q000378:metabolism*
D007378:Interleukins; D015375:Receptors, Interleukin-2