Association between interleukin-6 levels in amniotic fluid after rupture of membranes during labour at term pregnancy and successful vaginal delivery: a prospective cohort study.

We compared the mean interleukin-6 (IL-6) level in the amniotic fluid after rupture of membranes during labour at term pregnancy according to the delivery methods through prospective cohort study. Cases with premature rupture of membranes, multifetal pregnancy, and major congenital anomalies were excluded. Amniotic fluid was obtained from vaginal canal immediately after spontaneous rupture of membranes. A total of 47 cases were analysed, and 72.3% (34/47) had successful vaginal delivery. The mean concentration of IL-6 in the amniotic fluid was significantly higher in the vaginal delivery group than in the caesarean section group (5,229 pg/mL vs. 1,702 pg/mL, p = .022). The concentration of IL-6 from the amniotic fluid tended to increase as the cervical dilatation increased. The association between high IL-6 level (>2,500 pg/mL) and successful vaginal delivery was not significant after adjusting the degree of cervical dilatation in multivariate logistic regression analysis. IMPACT STATEMENTWhat is already known on this subject? Multiparity, active and strong uterine contractions, dilated cervical os, and the position of foetal head are known clinical factors affecting the successful vaginal delivery. There are few studies on markers for successful vaginal delivery in patients with labour.What do the results of this study add? The mean value of IL-6 concentration from the amniotic fluid collected from vagina immediately after rupture of membranes was significantly higher in the patients who had resulted in successful vaginal delivery than those who had failed.What are the implications are of these findings for clinical practice and/or further research? Measurement of IL-6 concentration in the amniotic fluid from vaginal canal in patients with labour might help to predict the successful vaginal delivery and shorten the time before decision of caesarean section.

Postoperative pain control with ropivacaine following laparoscopic myomectomy: A randomized double-blind, pilot study.

AIM: The aim of this study was to evaluate immediate pain control in patients who underwent laparoscopic myomectomy (LM) by intraoperative injection of ropivacaine into both uterosacral ligaments. METHODS: The study was a prospective, double-blind, randomized study. We analyzed 46 cases of LM performed between July 2015 and November 2016 by a single surgeon. We randomized the enrolled patients into either a ropivacaine or a saline injection group. Before the surgeon closed the abdominal wall, each 7.5% ropivacaine (5 mL) or saline (5 mL) was administered into both uterosacral ligaments through laparoscopic injection needle. We compared the pain intensity scores 2, 6, 12, and 24 h after injection between the two groups. RESULTS: The pain intensity scores were not significantly different. However, the ropivacaine group requested less of the analgesic than the placebo-injected group requested (P = 0.035). No patient in the ropivacaine group reported any side effects. CONCLUSION: Intraoperative ropivacaine injection into both uterosacral ligaments during LM can reduce the dosage of opioid analgesics.