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Am J Obstet Gynecol ; 211(4): 385.e1-9, 2014 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-24705131

RESUMO

OBJECTIVE: The objective of the study was to determine the diagnostic indices and predictive values by bedside assessment of amniotic fluid interleukin-6 (IL-6) concentration in the identification of microbial invasion of the amniotic cavity (MIAC) and/or histological chorioamnionitis (HCA) in patients with preterm prelabor rupture of membranes. STUDY DESIGN: One hundred twenty-four women with singleton pregnancies were included in this study. The amniotic fluid was sampled by transabdominal amniocentesis at the time of admission. IL-6 concentrations were assessed with an immunoassay. RESULTS: The presence of MIAC, HCA, or the coexistence of both was associated with higher amniotic fluid concentrations of IL-6 in both a crude and adjusted analysis. The amniotic fluid concentration of IL-6 of 1000 pg/mL was determined to be the best cutoff value for the prediction of MIAC (sensitivity of 50%, specificity of 95%, positive predictive value of 82%, negative predictive value of 81%, and likelihood ratio of 8.4) or both MIAC and HCA (sensitivity of 60%, specificity of 94%, positive predictive value of 75%, negative predictive value of 88%, and likelihood ratio of 9.4). CONCLUSION: The bedside assessment of amniotic fluid IL-6 seems to be an easy, rapid, and inexpensive method for the prediction of MIAC or both MIAC and HCA in pregnancies complicated by preterm prelabor rupture of membranes.


Assuntos
Amniocentese , Líquido Amniótico/metabolismo , Corioamnionite/diagnóstico , Interleucina-6/metabolismo , Infecções por Mycoplasma/diagnóstico , Sistemas Automatizados de Assistência Junto ao Leito , Complicações Infecciosas na Gravidez/diagnóstico , Adolescente , Adulto , Líquido Amniótico/microbiologia , Biomarcadores/metabolismo , Infecções por Chlamydia/diagnóstico , Chlamydia trachomatis/isolamento & purificação , Corioamnionite/metabolismo , Feminino , Ruptura Prematura de Membranas Fetais/metabolismo , Humanos , Mycoplasma hominis/isolamento & purificação , Valor Preditivo dos Testes , Gravidez , Complicações Infecciosas na Gravidez/metabolismo , Estudos Prospectivos , Sensibilidade e Especificidade , Infecções por Ureaplasma/diagnóstico , Infecções por Ureaplasma/metabolismo , Adulto Jovem
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