Neutrophil elastase and interleukin-6 in amniotic fluid as indicators of chorioamnionitis and funisitis.

OBJECTIVE

We wished to assess the diagnostic value of amniotic fluid concentrations of neutrophil elastase and interleukin-6 concentrations for the rapid detection of chorioamnionitis and funisitis.

STUDY

DESIGN

A retrospective study of 56 women who underwent transabdominal amniocentesis within 48 h before preterm delivery or spontaneous abortion. Statistical analyses included Student's t-test and Tukey-Kamer's HSD test. Receiver operating characteristics (ROC) curves were drawn to assess the predictive performance of the two markers.

RESULTS

Neutrophil elastase concentrations differed significantly between patients with chorioamnionitis and other stages of chorioamnionitis, while interleukin-6 concentrations did not. To predict chorioamnionitis, concentrations of 3563 ng/ml for neutrophil elastase and 11,279 pg/ml for interleukin-6 were optimal. Comparison of ROC curves showed that neutrophil elastase was a significantly more sensitive predictor of funisitis than interleukin-6.

CONCLUSION

Amniotic fluid concentrations of neutrophil elastase are more sensitive than interleukin-6 for the rapid detection of chorioamnionitis and funisitis.