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Background <p>PPROM is likely to be associated with microbial invasion of the amniotic cavity (MIAC), and the risk of developing intraamniotic inflammation (IAI) is high. Interleukin-6, a polyfunctional cytokine that is secreted by tissues in the fetomaternal interface in response to microbial products, has been implicated in the host response to intrauterine infection. Measuring cervicovaginal fluid concentrations of interleukin-6 could be of value in diagnosis of microbial invasion of the amniotic cavity.</p> Purpose of Study <p>To evaluate the collected vaginal fluid IL-6 concentration as a new diagnostic tool for monitoring of intraamniotic infection after PPROM and to compare the potential of IL-6 with the established inflammatory parameters like maternal WBC counts and CRP levels in blood.</p> Methods <p>Prospective observational study was performed on 100 patients for a duration of 1 year in a tertiary care institute. Patients diagnosed with PPROM were included in study after proper institutional and ethical approval. Cervicovaginal fluid was collected and sent for IL-6 testing by electrochemiluminescence immunoassay kit. Inflammation and control groups were analysed using ROC curve, IBM SPSS-29 and OriginPro.</p> Results <p>The prevalence of intrauterine infection/inflammation was 48.96%. A statistically significant association was observed between short admission–delivery interval, lower APGAR score and patients with IAI (p – 0.001). Among various methods to diagnose IAI , IL-6 in cervicovaginal fluid has the highest sensitivity (95.74%) and specificity (95.92%).</p> Conclusion <p>This study established a new noninvasive test of assessing IL-6 in cervicovaginal fluid for monitoring IAI in PPROM patients.The inflammatory group had a considerably greater median concentration of IL-6 in vaginal fluid before delivery than the control group. Considering all other maternal routine parameters (WBC, CRP blood), the AUC was higher for IL-6 (vag) concentration. This provides a significant benefit in determining a suitable delivery time. As a result, measuring IL-6 (vag) may improve the clinical care of PPROM patients.</p>

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Interleukin 6 (IL-6) in Cervico-Vaginal Fluid, A Diagnostic and Prognostic Tool for Intra Amniotic Infection/Inflammation in Preterm Premature Rupture of Membranes (PPROM)

  • 期刊论文

  • 发表日期：

    2025年11月12日

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  • Priya Saini,
  • Arshdeep Kour,
  • Rahul Sharma,
  • Jyotsana Lamba

摘要

Background

PPROM is likely to be associated with microbial invasion of the amniotic cavity (MIAC), and the risk of developing intraamniotic inflammation (IAI) is high. Interleukin-6, a polyfunctional cytokine that is secreted by tissues in the fetomaternal interface in response to microbial products, has been implicated in the host response to intrauterine infection. Measuring cervicovaginal fluid concentrations of interleukin-6 could be of value in diagnosis of microbial invasion of the amniotic cavity.

Purpose of Study

To evaluate the collected vaginal fluid IL-6 concentration as a new diagnostic tool for monitoring of intraamniotic infection after PPROM and to compare the potential of IL-6 with the established inflammatory parameters like maternal WBC counts and CRP levels in blood.

Methods

Prospective observational study was performed on 100 patients for a duration of 1 year in a tertiary care institute. Patients diagnosed with PPROM were included in study after proper institutional and ethical approval. Cervicovaginal fluid was collected and sent for IL-6 testing by electrochemiluminescence immunoassay kit. Inflammation and control groups were analysed using ROC curve, IBM SPSS-29 and OriginPro.

Results

The prevalence of intrauterine infection/inflammation was 48.96%. A statistically significant association was observed between short admission–delivery interval, lower APGAR score and patients with IAI (p – 0.001). Among various methods to diagnose IAI , IL-6 in cervicovaginal fluid has the highest sensitivity (95.74%) and specificity (95.92%).

Conclusion

This study established a new noninvasive test of assessing IL-6 in cervicovaginal fluid for monitoring IAI in PPROM patients.The inflammatory group had a considerably greater median concentration of IL-6 in vaginal fluid before delivery than the control group. Considering all other maternal routine parameters (WBC, CRP blood), the AUC was higher for IL-6 (vag) concentration. This provides a significant benefit in determining a suitable delivery time. As a result, measuring IL-6 (vag) may improve the clinical care of PPROM patients.