Endocervical hyaluronan and ultrasound-indicated cerclage.
OBJECTIVE
To investigate whether, at the time of ultrasound-indicated cerclage, the endocervical concentration of hyaluronan (HA), 27-kDa heat shock protein (HSP-27) and/or interleukin-8 (IL-8) would predict pregnancy outcome.


METHODS
Endocervical samples, obtained from 40 women undergoing ultrasound-indicated cerclage at 15 + 3 to 25 + 0 weeks' gestation, were assayed by enzyme-linked immunosorbent assay for HA, HSP-27 and IL-8. All subjects had a cervical length of < 1.5 cm or dramatic cervical length change on serial endovaginal ultrasound, no uterine contractions or tenderness, no fever and intact membranes and underwent a modified Shirodkar cerclage.


RESULTS
The median HA level was 10.0 ng/mL in the 12 women who delivered at < 37 weeks' gestation as opposed to 39.7 ng/mL in the 28 women delivering at 37-41 weeks (P = 0.017). Median HSP-27 and IL-8 concentrations were not significantly different in these groups.


CONCLUSIONS
A higher endocervical HA level at the time of ultrasound-indicated cerclage is associated with a longer interval before birth.
Eglinton
G S
GS
Department of Obstetrics and Gynecology, New York Hospital Queens, New York, NY, USA.
Herway
C
C
Skupski
D W
DW
Bongiovanni
A M
AM
Witkin
S S
SS
D000328:Adult; D015415:Biomarkers / Q000032:analysis / Q000378:metabolism; D023802:Cerclage, Cervical / Q000379:methods; D002584:Cervix Uteri / Q000000981:diagnostic imaging / Q000601:surgery; D017558:Elective Surgical Procedures; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D055551:HSP27 Heat-Shock Proteins / Q000032:analysis / Q000378:metabolism*; D006360:Heat-Shock Proteins; D006801:Humans; D006820:Hyaluronic Acid / Q000032:analysis / Q000378:metabolism*; D016209:Interleukin-8 / Q000032:analysis / Q000378:metabolism*; D018832:Molecular Chaperones; D011237:Predictive Value of Tests; D011247:Pregnancy; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D016216:Ultrasonography, Prenatal; D002581:Uterine Cervical Incompetence / Q000000981:diagnostic imaging* / Q000601:surgery; D055815:Young Adult
D015415:Biomarkers; D055551:HSP27 Heat-Shock Proteins; C057725:HSPB1 protein, human; D006360:Heat-Shock Proteins; D016209:Interleukin-8; D018832:Molecular Chaperones; D006820:Hyaluronic Acid