Rapid evaluation of the absence of inflammation after rupture of membranes

Berthiaume, Maryse; Rousseau, Éric; Rola‐Pleszczynski, Marek; Pasquier, Jean-Charles

doi:10.3109/14767058.2013.829814

Cited by 12 publications

(13 citation statements)

References 28 publications

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“…Second, the bedside amniotic fluid IL-6 concentrations were not confirmed by a separate complementary technique (eg, ELISA). However, the study by Berthiaume et al 16 recently showed a good correlation between ELISA and bedside immunochromatographic IL-6 results. Third, we did not specifically evaluate the 16S ribosomal ribonucleic acid in the amniotic fluid, and we could not exclude the presence of uncultivated bacteria in women without MIAC.…”

Section: Principal Findings Of This Studymentioning

confidence: 95%

“…Additionally, some investigators have reported that IL-6 determinations can be performed at the bedside. [14][15][16] Despite the fact that bedside IL-6 has been tested on the cervicovaginal fluid of PPROM pregnancies, there is a paucity of information on the diagnostic and prognostic value of this test of amniotic fluid retrieved by transabdominal amniocentesis form PPROM pregnancies. [13][14][15] An accurate and rapid IL-6 bedside test would be of great clinical utility in predicting PPROM complications.…”

mentioning

confidence: 99%

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Bedside assessment of amniotic fluid interleukin-6 in preterm prelabor rupture of membranes

Kacerovský

Musilová

Hornychová

et al. 2014

American Journal of Obstetrics and Gynecology

101

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Section: Principal Findings Of This Studymentioning

confidence: 95%

mentioning

confidence: 99%

Bedside assessment of amniotic fluid interleukin-6 in preterm prelabor rupture of membranes

Kacerovský

Musilová

Hornychová

et al. 2014

American Journal of Obstetrics and Gynecology

101

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“…Recent studies suggest that amniotic fluid IL-6 is equivalent to other techniques, such as proteomic analysis of amniotic fluid [353], and rapid assays are now available that provide results within 20 minutes [120,124,125,354–356]. These assays allow IL-6 to be used as a point-of-care test [120,124,125,354–356]. …”

Section: Discussionmentioning

confidence: 99%

Clinical chorioamnionitis at term IV: the maternal plasma cytokine profile

Romero¹,

Chaemsaithong²,

Docheva³

et al. 2015

Journal of Perinatal Medicine

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Introduction Fever is a major criterion for clinical chorioamnionitis; yet, many patients with intrapartum fever do not have demonstrable intra-amniotic infection. Some cytokines, such as interleukin (IL)-1, IL-6, interferon-gamma (IFN-γ) and tumor necrosis factor-alpha (TNF-α) can induce a fever. The objective of this study was to determine whether maternal plasma concentrations of cytokines could be of value in the identification of patients with the diagnosis of clinical chorioamnionitis at term who have microbial-associated intra-amniotic inflammation. Methods A retrospective cross-sectional study was conducted, including patients with clinical chorioamnionitis at term (n=41; cases) and women in spontaneous labor at term without clinical chorioamnionitis (n=77; controls). Women with clinical chorioamnionitis were classified into three groups according to the results of amniotic fluid cultures, broad-range polymerase chain reaction coupled with electrospray ionization mass spectrometry (PCR/ESI-MS), and amniotic fluid IL-6 concentrations: 1) no intra-amniotic inflammation; 2) intra-amniotic inflammation without detectable microorganisms; or 3) microbial-associated intra-amniotic inflammation. The maternal plasma concentrations of 29 cytokines were determined with sensitive and specific V-PLEX immunoassays. Nonparametric statistical methods were used for analysis, adjusting for a false discovery rate of 5%. Results 1) The maternal plasma concentrations of pyrogenic cytokines (IL-1β, IL-2, IL-6, IFN-γ and TNF-α) were significantly higher in patients with clinical chorioamnionitis at term than in those with spontaneous term labor without clinical chorioamnionitis; 2) the maternal plasma concentrations of cytokines were not significantly different among the three subgroups of patients with clinical chorioamnionitis (intra-amniotic inflammation with and without detectable bacteria and those without intra-amniotic inflammation); and 3) among women with the diagnosis of clinical chorioamnionitis, but without evidence of intra-amniotic inflammation, the maternal plasma concentrations of pyrogenic cytokines were significantly higher than in patients with spontaneous labor at term. These observations suggest that the fever can be mediated by increased circulating concentrations of these cytokines, despite the absence of a local intra-amniotic inflammatory response. Conclusions 1) The maternal plasma concentrations of pyrogenic cytokines (e.g. IL-1β, IL-2, IL-6, IFN-γ and TNF-α) are higher in patients with intra-partum fever and the diagnosis of clinical chorioamnionitis at term than in those in spontaneous labor at term without a fever; and 2) maternal plasma cytokine concentrations have limited value in the identification of patients with bacteria in the amniotic cavity. Accurate assessment of the presence of intra-amniotic infection requires amniotic fluid analysis.

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“…A high negative predictive value (97%) has also been reported for a point of care vaginal fluid IL-6 concentration in identifying intra-amniotic inflammation in patients with rupture of membranes [154]. …”

Section: Discussionmentioning

confidence: 99%

“…Kacerovsky et al have recently reported the use of a point of care (POC) test for IL-6 in preterm prelabor rupture of membranes (PROM), which uses lateral-flow immunoassays [113]. Other investigators have used determination of IL-6 in vaginal fluid [153,154] as a point of care test.…”

Section: Introductionmentioning

confidence: 99%

A point of care test for the determination of amniotic fluid interleukin-6 and the chemokine CXCL-10/IP-10

Chaemsaithong

Romero

Korzeniewski

et al. 2014

The Journal of Maternal-Fetal & Neonatal Medicine

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Objective Intra-amniotic inflammation is a mechanism of disease implicated in preterm labor, preterm PROM, cervical insufficiency, a short cervix, and idiopathic vaginal bleeding. Determination of interleukin (IL)-6 with immunoassays has been proven for more than 2 decades to be an excellent method for the detection of intra-amniotic inflammation. However, assessment of IL-6 for this indication has been based on immunoassays which are not clinically available, and this has been an obstacle for the implementation of this test in clinical practice. It is now possible to obtain results within 20 minutes with a point of care test which requires minimal laboratory support. This test is based on lateral flow-based immunoassay. The objective of this study was to compare amniotic fluid (AF) IL-6 and interferon-γ –inducible protein 10 (IP-10 or CXCL-10) concentrations determined using lateral flow-based immunoassay or point of care (POC) test and standard enzyme-linked immunosorbent assay (ELISA) techniques. Material and methods AF samples were collected from patients with singleton gestations and symptoms of preterm labor (n=20). AF IL-6 and IP-10 concentrations were determined by lateral flow-based immunoassay and ELISA. Intra-amniotic inflammation was defined as AF IL-6 > 2.6 ng/ml. AF IL-6 and IP-10 concentrations between two assays were compared. Results 1) Lateral flow-based immunoassay point of care AF IL-6 and IP-10 test results were strongly correlated with concentrations of this cytokine/chemokine determined by ELISA (Spearman's ρ =0.92 and 0.83, respectively, both p < 0.0001); 2) AF IL-6 concentrations determined by the lateral flow-based immunoassay test were, on average, 30% lower than those determined by ELISA, and the median difference was statistically significant (p < 0.0001); and 3) in contrast, AF IP-10 concentrations determined by the lateral flow-based immunoassay test were, on average, only 7% lower than those determined by ELISA, and the median difference was not statistically significant (p =0.81). Conclusion Amniotic fluid IL-6 and IP-10 concentrations determined using a lateral flow-based immunoassay point of care are strongly correlated with concentrations determined by conventional ELISA. This justifies further studies about the diagnostic indices and predictive values of this point of care test.

show abstract

Rapid evaluation of the absence of inflammation after rupture of membranes

Abstract: Our findings show that a bedside test can detect the absence of IL6 in vaginal secretions. This result suggests that bedside test could be used for expectant management after premature PROM to inform the attending physician of the absence of inflammation in vaginal secretions.

Cited by 12 publications

References 28 publications

Bedside assessment of amniotic fluid interleukin-6 in preterm prelabor rupture of membranes

Bedside assessment of amniotic fluid interleukin-6 in preterm prelabor rupture of membranes

Clinical chorioamnionitis at term IV: the maternal plasma cytokine profile

A point of care test for the determination of amniotic fluid interleukin-6 and the chemokine CXCL-10/IP-10

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