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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 J+Matern+Fetal+Neonatal+Med
2016 ; 29
(3
): 360-7
Nephropedia Template TP
gab.com Text
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English Wikipedia
A point of care test for interleukin-6 in amniotic fluid in preterm prelabor
rupture of membranes: a step toward the early treatment of acute intra-amniotic
inflammation/infection
#MMPMID25758620
Chaemsaithong P
; Romero R
; Korzeniewski SJ
; Martinez-Varea A
; Dong Z
; Yoon BH
; Hassan SS
; Chaiworapongsa T
; Yeo L
J Matern Fetal Neonatal Med
2016[]; 29
(3
): 360-7
PMID25758620
show ga
OBJECTIVE: Preterm prelabor rupture of membranes (preterm PROM) accounts for
30-40% of spontaneous preterm deliveries and thus is a major contributor to
perinatal morbidity and mortality. An amniotic fluid (AF) interleukin-6 (IL-6)
concentration is a key cytokine for the identification of intra-amniotic
inflammation, patients at risk of impending preterm delivery and adverse
pregnancy complications. The conventional method to determine IL-6 concentrations
in AF is an enzyme-linked immunosorbent assay (ELISA). However, this technique is
not available in clinical settings, and the results may take several days. A
lateral flow-based immunoassay, or point of care (POC) test, has been developed
to address this issue. The objective of this study was to compare the performance
of AF IL-6 determined by the POC test to that determined by ELISA for the
identification of intra-amniotic inflammation in patients with preterm PROM.
MATERIALS AND METHODS: This retrospective cohort study includes 56 women with
singleton pregnancies who presented with preterm PROM. Amniocentesis was
performed at the time of diagnosis, and AF was analyzed using cultivation
techniques for aerobic and anaerobic bacteria as well as genital mycoplasmas. AF
Gram stain and AF white blood cell counts were determined. AF IL-6 concentrations
were measured using both lateral flow-based immunoassay and ELISA. The primary
outcome was intra-amniotic inflammation defined as AF ELISA IL-6???2600?pg/ml. A
previously determined cut-off of 745?pg/ml was used to define a positive POC
test. RESULTS: (1) The POC test for AF IL-6 concentrations had 97% sensitivity
and 96% specificity for the identification of intra-amniotic inflammation, as
defined using ELISA among patients with preterm PROM and (2) the diagnostic
performance of the POC test for IL-6 was strongly correlated to that of an ELISA
test for the identification of intra-amniotic inflammation and was equivalent for
the identification of acute inflammatory placental lesions and microbial invasion
of the amniotic cavity (MIAC). CONCLUSION: A POC AF IL-6 test can identify
intra-amniotic inflammation in patients with preterm PROM. Results can be
available within 20?min - this makes it possible to implement interventions
designed to treat intra-amniotic inflammation and improve pregnancy outcomes.