| Interleukin-6, but not relaxin, predicts outcome of rescue cerclage in women with cervical incompetence. | |
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MedLine Citation:
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PMID: 15467541 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Keun-Young Lee; Hyun-Ah Jun; Hong-Bae Kim; Sung-Won Kang |
Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: American journal of obstetrics and gynecology Volume: 191 ISSN: 0002-9378 ISO Abbreviation: Am. J. Obstet. Gynecol. Publication Date: 2004 Sep |
Date Detail:
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Created Date: 2004-10-06 Completed Date: 2004-11-06 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0370476 Medline TA: Am J Obstet Gynecol Country: United States |
Other Details:
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Languages: eng Pagination: 784-9 Citation Subset: AIM; IM |
Affiliation:
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Department of Obstetrics and Gynecology, Hallym University, College of Medicine, Kangnam Sacred Heart Hospital, Seoul, Korea. mfmlee@hallym.ac.kr |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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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:
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0/Interleukin-6; 9002-69-1/Relaxin |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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