Amniotic fluid inflammation with negative culture and outcome after cervical cerclage.

Abstract

OBJECTIVE:

To determine whether amniotic fluid (AF) inflammation, in the absence of infection, is associated with adverse pregnancy outcomes in nonelective cervical cerclage patients.

METHODS:

A retrospective case-control study was carried out. The patient population included 82 singleton pregnancies with negative AF cultures. The variables used to define AF inflammation were white blood cell count (WBC) >50 cell/mm(3), glucose <14 mg/dl or interleukin-6 (IL-6) >11.3 ng/ml. The study group consisted of cases with intra-amniotic inflammation. Sub-analysis was performed for the groups in which IL-6 concentrations were measured. Adverse outcomes were evaluated with variables such as gestational age at delivery, interval from cerclage to delivery, chorioamnionitis and cumulative neonatal morbidity.

RESULTS:

Elevated AF WBC was correlated with severe and extreme preterm delivery (p < 0.05). Decreased AF glucose was associated with histological chorioamnionitis and a decreased cerclage to delivery interval (p < 0.05). Elevated AF IL-6 correlated significantly with decreased gestational age at delivery (p < 0.012) and decreased cerclage to delivery interval (p < 0.001). Elevated IL-6 concentrations were associated with severe, extreme preterm delivery (p < 0.001) and neonatal death (p < 0.001).

CONCLUSION:

Elevated AF IL-6, elevated WBC and low AF glucose, in the absence of a positive AF culture, are significantly associated with adverse pregnancy outcomes in patients undergoing nonelective cerclage.

• Authors: Eduardo Aguin, Tina Aguin, Marcos Cordoba, Victor Aguin, Robyn Roberts, Samet Albayrak, Michael Kruger, Ray Bahado-Singh
• Journal: The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians (J Matern Fetal Neonatal Med) Vol. 25 Issue 10 Pg. 1990-4 (Oct 2012) ISSN: 1476-4954 [Electronic] England
• PMID: 22372938 (Publication Type: Journal Article)

Chemical References

• Biomarkers
• Interleukin-6
• Glucose

Topics

• Adult
• Amniocentesis
• Amniotic Fluid (immunology, metabolism)
• Biomarkers (metabolism)
• Case-Control Studies
• Cerclage, Cervical
• Chorioamnionitis (etiology, pathology)
• Female
• Gestational Age
• Glucose (metabolism)
• Humans
• Infant, Newborn
• Infant, Premature
• Infant, Premature, Diseases (etiology, mortality)
• Inflammation (diagnosis, immunology, metabolism)
• Interleukin-6 (metabolism)
• Leukocyte Count
• Pregnancy
• Premature Birth (etiology, prevention & control)
• Retrospective Studies
• Uterine Cervical Incompetence (surgery)