Objective
Preterm prelabor rupture of membranes (PPROM) is responsible for approximately one-third of all preterm deliveries. The most common complication associated with PPROM is intraamniotic inflammation (IAI), either infection related or sterile. Among the different potential markers for IAI identification, a traditional amniotic fluid marker, interleukin (IL)-6, appears to be the optimal choice. The availability of the point of care (POC) IL-6 test is very important from a clinical prospective. A recent study in which IL-6 was measured by the POC test in the processed amniotic fluid samples from a biobank (a centrifuged sample that underwent a frozen-thawed cycle) suggested a cut-off amniotic fluid IL-6 of 745 pg/mL for the detection of IAI in PPROM. Clinicians would prefer to use fresh, noncentrifuged amniotic fluid than processed samples for the IL-6 POC test. However, there is a lack of information regarding the comparison between the amniotic fluid IL-6 concentrations measured by the POC test in the fresh and processed samples. The aim of this study was to test whether the amniotic fluid IL-6 POC cut-off of 745 pg/mL could be used for the identification of IAI in fresh, noncentrifuged amniotic fluid from PPROM cases.
Study Design
From January 2014 through February 2015, a prospective study was conducted on pregnant women at the gestational ages of 24+0 or 36+6 weeks who were admitted to the Department of Obstetrics and Gynecology, University Hospital Hradec Kralove, Czech Republic. Pregnant women with singleton pregnancies complicated by PPROM and with a maternal age ≥18 years were invited to participate in the study. In total, 98 women with PPROM were included in the study. Ultrasound-guided transabdominal amniocentesis was performed at admission before the administration of antibiotics, corticosteroids, and tocolytics. Amniotic fluid IL-6 was assessed in fresh, noncentrifuged amniotic fluid. The remaining amniotic fluid was immediately centrifuged for 10 minutes at 2000 g at 4°C to remove cells and debris, and then the samples were divided into aliquots and stored at –80°C until analysis (April 2015). IL-6 was assessed with a Milenia QuickLine IL-6 lateral flow immunoassay using a Milenia POCScan reader (Millenia Biotec GmbH, Giessen, Germany) in the fresh and processed amniotic fluid samples. The measurement range was 50–10,000 pg/mL. A correlation between the amniotic fluid IL-6 concentrations in the fresh and processed samples was assessed using Spearman correlation coefficients. A Bland-Altman plot was constructed. A value of P < .05 was considered significant.
Study Design
From January 2014 through February 2015, a prospective study was conducted on pregnant women at the gestational ages of 24+0 or 36+6 weeks who were admitted to the Department of Obstetrics and Gynecology, University Hospital Hradec Kralove, Czech Republic. Pregnant women with singleton pregnancies complicated by PPROM and with a maternal age ≥18 years were invited to participate in the study. In total, 98 women with PPROM were included in the study. Ultrasound-guided transabdominal amniocentesis was performed at admission before the administration of antibiotics, corticosteroids, and tocolytics. Amniotic fluid IL-6 was assessed in fresh, noncentrifuged amniotic fluid. The remaining amniotic fluid was immediately centrifuged for 10 minutes at 2000 g at 4°C to remove cells and debris, and then the samples were divided into aliquots and stored at –80°C until analysis (April 2015). IL-6 was assessed with a Milenia QuickLine IL-6 lateral flow immunoassay using a Milenia POCScan reader (Millenia Biotec GmbH, Giessen, Germany) in the fresh and processed amniotic fluid samples. The measurement range was 50–10,000 pg/mL. A correlation between the amniotic fluid IL-6 concentrations in the fresh and processed samples was assessed using Spearman correlation coefficients. A Bland-Altman plot was constructed. A value of P < .05 was considered significant.
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