Abstract
Objective. Infection is likely to contribute to preterm birth (PTB). Laboratory analysis has demonstrated that vaginal IL-6 is correlated with PTB. We aimed to investigate a bedside test in this context.
Method. Vaginal secretions were collected from 71 asymptomatic high-risk women. After 20 minutes incubation at room temperature, samples were analyzed by the bedside reader (IL-6 concentration in pg/ml) (Milenia-Biotec, Germany). Maternal and neonatal infectious markers and pregnancy outcome were recorded.
Results. IL-6 was related to PTB, latency to gestation and maternal infection but not neonatal infection. In women with visible fetal membranes (n = 13), all of those with a high IL-6 (≥56 pg/ml) had a PTB (n = 11) compared to half (n = 1) with a low IL-6 (<56 pg/ml). All the women with a high IL-6 at <24 weeks' (n = 10) delivered before viability compared to none with a low IL-6 (n = 2). In women with preterm prelabor rupture of membrane (PPROM) and high IL-6 (n = 8) there was a trend toward more extreme PTB's (57% vs. 0%, p = 0.19) and delivery within 7 days (71% vs. 50%, p = 0.09) compared to low IL-6 (n = 5).
Conclusion. IL-6 may be useful in guiding the difficult management of patients with visible membranes and PPROM, for example, the potential benefit of a cervical cerclage.
Acknowledgements
Oral presentation at the Innovations & Progress in Healthcare for Women 2nd Annual Conference, London 2009. Poster Presentation at Blair Bell Research Society Annual Meeting, London 2009; 14th British Maternal Fetal Medicine Society Annual Conference, Newcastle 2010; and 22nd European Conference of Perinatal Medicine, Granada 2010. The authors thank the women that participated in this study and the staff of St. Thomas' Hospital London. Funded by Guy's and St Thomas' Charity, London, SE1 9RT.
Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.