Relation between interleukin-6 in the cervicovaginal fluid and subclinical chorioamnionitis in patients with preterm premature rupture of membranes

ObjectiveTo evaluate the accuracy of the interleukin-6 (IL-6) in the cervicovaginal fluid to diagnose subclinical chorioamnionitis and neonatal infection in patients with preterm premature rupture of membranes (PPROM).MethodsOne hundred and twenty (120) pregnant women > 34 weeks, and < 37 weeks gestation with PPROM were included in this study. Patients included in this study were subjected to standard examination, trans-abdominal ultrasound, sterile speculum examination to detect amniotic fluid pooling through the cervical canal and for assessment of the IL-6 in the cervicovaginal secretions. After delivery, all neonates were examined for detection of neonatal infection and all placentae and membranes were histological examined for detection of chorioamnionitis.ResultsThe sensitivity & specificity of Interleukin-6 test to diagnose neonatal infection were 82.8% & 89.3%; respectively, while the Interleukin-6 test sensitivity & specificity to diagnose chorioamnionitis were 90.7% & 91.0%; respectively. The positive predictive value (PPV) & negative predictive value (NPV) of Interleukin-6 test to diagnose neonatal infection were 86.9% & 85.9%; respectively, while the Interleukin-6 test PPV & NPV to diagnose chorioamnionitis were 87.5% & 93.4%; respectively. The accuracy of Interleukin-6 test to diagnose neonatal infection was 86.3%, while the accuracy of Interleukin-6 test to diagnose chorioamnionitis was 90.9%.ConclusionsDetection of Interleukin-6 in the cervicovaginal secretion is a sensitive, non-invasive prenatal marker for neonatal infection and subclinical chorioamnionitis in patients with PPROM.