Bedside assessment of amniotic fluid interleukin-6 in preterm prelabor rupture of membranes.
OBJECTIVE
The objective of the study was to determine the diagnostic indices and predictive values by bedside assessment of amniotic fluid interleukin-6 (IL-6) concentration in the identification of microbial invasion of the amniotic cavity (MIAC) and/or histological chorioamnionitis (HCA) in patients with preterm prelabor rupture of membranes.


METHODS
One hundred twenty-four women with singleton pregnancies were included in this study. The amniotic fluid was sampled by transabdominal amniocentesis at the time of admission. IL-6 concentrations were assessed with an immunoassay.


RESULTS
The presence of MIAC, HCA, or the coexistence of both was associated with higher amniotic fluid concentrations of IL-6 in both a crude and adjusted analysis. The amniotic fluid concentration of IL-6 of 1000 pg/mL was determined to be the best cutoff value for the prediction of MIAC (sensitivity of 50%, specificity of 95%, positive predictive value of 82%, negative predictive value of 81%, and likelihood ratio of 8.4) or both MIAC and HCA (sensitivity of 60%, specificity of 94%, positive predictive value of 75%, negative predictive value of 88%, and likelihood ratio of 9.4).


CONCLUSIONS
The bedside assessment of amniotic fluid IL-6 seems to be an easy, rapid, and inexpensive method for the prediction of MIAC or both MIAC and HCA in pregnancies complicated by preterm prelabor rupture of membranes.
Biomedical Research Center, University Hospital Hradec Kralove, Czech Republic; Department of Obstetrics and Gynecology, Charles University in Prague, Faculty of Medicine Hradec Kralove, University Hospital Hradec Kralove, Czech Republic. Electronic address: kacermar@fnhk.cz.
Marian
M
Kacerovsky
Department of Obstetrics and Gynecology, Charles University in Prague, Faculty of Medicine Hradec Kralove, University Hospital Hradec Kralove, Czech Republic.
Ivana
I
Musilova
Fingerland Department of Pathology, Charles University in Prague, Faculty of Medicine Hradec Kralove, University Hospital Hradec Kralove, Czech Republic.
Helena
H
Hornychova
Institute of Clinical Biochemistry and Diagnostics, Charles University in Prague, Faculty of Medicine Hradec Kralove, University Hospital Hradec Kralove, Czech Republic.
Radka
R
Kutova
Institute of Clinical Biochemistry and Diagnostics, Charles University in Prague, Faculty of Medicine Hradec Kralove, University Hospital Hradec Kralove, Czech Republic.
Lenka
L
Pliskova
Department of Obstetrics and Gynecology, University Hospital Pardubice, Pardubice, Czech Republic.
Milan
M
Kostal
Department of Obstetrics and Gynecology, Sahlgrenska University Hospital, Gothenburg, Sweden, and Department of Public Health, Oslo University, Oslo, Norway.
Bo
B
Jacobsson
D000293:Adolescent; D000328:Adult; D000649:Amniocentesis; D000653:Amniotic Fluid / Q000378:metabolism* / Q000382:microbiology; D015415:Biomarkers / Q000378:metabolism; D002690:Chlamydia Infections / Q000175:diagnosis; D002692:Chlamydia trachomatis / Q000302:isolation & purification; D002821:Chorioamnionitis / Q000175:diagnosis* / Q000378:metabolism; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000378:metabolism; D006801:Humans; D015850:Interleukin-6 / Q000378:metabolism*; D009175:Mycoplasma Infections / Q000175:diagnosis*; D019535:Mycoplasma hominis / Q000302:isolation & purification; D019095:Point-of-Care Systems; D011237:Predictive Value of Tests; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis* / Q000378:metabolism; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D016869:Ureaplasma Infections / Q000175:diagnosis / Q000378:metabolism; D055815:Young Adult
D015415:Biomarkers; D015850:Interleukin-6
amniotic fluid; cytokine; histological chorioamnionitis; interleukin-6; microbial invasion of the amniotic fluid