Objective We investigated the poten tial roles of relaxin and subclinical intra -amniotic inflam mation by quantitating amniotic fluid relaxin and interleu kin -6concentrations for the prediction of outcome of rescue c erclage in women with cervical incompetence.Study desig n Cervical incompe-tence was diagnosed when cervical di latation exceeded 2cm with intact but bulging membranes an d no detectable uter-ine activity.Each woman underwent a mniocentesis to fa-cilitate the performance of a rescue cerclage between 15and 27weeks of gestation(n =40women).Forty -five additional women who underwent amni ocentesis for chro-mosomal testing between 16and 27weeks of gestation served as a control group.All contro l patients were de-livered of chromosomally normal inf ants at>37weeks of gestation.All cases and control patients were singleton gestations.Interleukin -6and rela xin were determined in all amniotic fluid samples by enzyme -linked im-munosorbent assay.Results Amnioti c fluid interleukin -6levels were significantly higher in women with cervical incompetence than in control patien ts(control patients,50.4pg /mLrange,19.4-97.4pg /mLvs cervical incompetence patients,5459.1pg /m Lrange,1131.4-14425.7pg /mL;P <.001).In contrast to inter-leukin -6,relaxin levels did not dif fer between the 2groups(control patients,67.5pg /mLrange,35.1-153.5pg /mLvs cervical incompetence patients,45.6pg /mLrange,30.1-75.5pg /mL;P =.061).There was a significant difference i n interleukin -6lev-els in women with shorter latencies(P<.01for all latency intervals that were examined:delivery within 24hours,3days,7days,before 33and 37completed weeks of gestation).Linear regression analysis with th e use of the latency interval from cerclage to delivery as the depen-dent and with interleukin -6as the in dependent variable revealed a significant inverse rela tionship(r =-0.62;P<.001after log transformation of int erleukin -6).There was no relationship on regression analysis between relaxin and the latency interval.Co nclusion Amniotic fluid interleukin -6is increased in patie nts with cervical incom-petence,which suggests that subcli nical inflammation may contribute to cervical incompetence.Further,an elevated interleukin -6level predicts a cerc lage short -latency in-terval between cerclage and delivery.In contrast with inter-leukin -6,amniotic fluid relaxin does not appear to con-tribute to cervical incompetence -i nduced cervical dilation.
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