Document Detail


Interleukin-6, but not relaxin, predicts outcome of rescue cerclage in women with cervical incompetence.
MedLine Citation:
PMID:  15467541     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: We investigated the potential roles of relaxin and subclinical intra-amniotic inflammation by quantitating amniotic fluid relaxin and interleukin-6 concentrations for the prediction of outcome of rescue cerclage in women with cervical incompetence. STUDY DESIGN: Cervical incompetence was diagnosed when cervical dilatation exceeded 2 cm with intact but bulging membranes and no detectable uterine activity. Each woman underwent amniocentesis to facilitate the performance of a rescue cerclage between 15 and 27 weeks of gestation (n=40 women). Forty-five additional women who underwent amniocentesis for chromosomal testing between 16 and 27 weeks of gestation served as a control group. All control patients were delivered of chromosomally normal infants at>37 weeks of gestation. All cases and control patients were singleton gestations. Interleukin-6 and relaxin were determined in all amniotic fluid samples by enzyme-linked immunosorbent assay. RESULTS: Amniotic fluid interleukin-6 levels were significantly higher in women with cervical incompetence than in control patients (control patients, 50.4 pg/mL [range, 19.4-97.4 pg/mL] vs cervical incompetence patients, 5459.1 pg/mL [range, 1131.4-14425.7 pg/mL] ; P < .001). In contrast to interleukin-6, relaxin levels did not differ between the 2 groups (control patients, 67.5 pg/mL [range, 35.1-153.5 pg/mL] vs cervical incompetence patients, 45.6 pg/mL [range, 30.1-75.5 pg/mL]; P=.061). There was a significant difference in interleukin-6 levels in women with shorter latencies (P < .01 for all latency intervals that were examined: delivery within 24 hours, 3 days, 7 days, before 33 and 37 completed weeks of gestation). Linear regression analysis with the use of the latency interval from cerclage to delivery as the dependent and with interleukin-6 as the independent variable revealed a significant inverse relationship (r=-0.62; P < .001 after log transformation of interleukin-6). There was no relationship on regression analysis between relaxin and the latency interval. CONCLUSION: Amniotic fluid interleukin-6 is increased in patients with cervical incompetence, which suggests that subclinical inflammation may contribute to cervical incompetence. Further, an elevated interleukin-6 level predicts a cerclage short-latency interval between cerclage and delivery. In contrast with interleukin-6, amniotic fluid relaxin does not appear to contribute to cervical incompetence-induced cervical dilation.
Authors:
Keun-Young Lee; Hyun-Ah Jun; Hong-Bae Kim; Sung-Won Kang
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  American journal of obstetrics and gynecology     Volume:  191     ISSN:  0002-9378     ISO Abbreviation:  Am. J. Obstet. Gynecol.     Publication Date:  2004 Sep 
Date Detail:
Created Date:  2004-10-06     Completed Date:  2004-11-06     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0370476     Medline TA:  Am J Obstet Gynecol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  784-9     Citation Subset:  AIM; IM    
Affiliation:
Department of Obstetrics and Gynecology, Hallym University, College of Medicine, Kangnam Sacred Heart Hospital, Seoul, Korea. mfmlee@hallym.ac.kr
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MeSH Terms
Descriptor/Qualifier:
Adult
Amniotic Fluid / chemistry*
Cerclage, Cervical*
Female
Gestational Age
Humans
Interleukin-6 / analysis*
Korea
Parity
Pregnancy
Prospective Studies
ROC Curve
Regression Analysis
Relaxin / analysis*
Time Factors
Treatment Outcome*
Uterine Cervical Incompetence / surgery*
Chemical
Reg. No./Substance:
0/Interleukin-6; 9002-69-1/Relaxin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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