Cytokines may predict funisitis in PPROM. (Maternal Serum Examined).

BANFF, ALTA.--Levels of certain cytokines in maternal serum may help predict which patients with preterm premature rupture of the membranes are likely to develop funisitis.

In the setting of preterm premature rupture of the membranes (PPROM), the fetus is at increased risk for infectious morbidity, yet prompt diagnosis of infection is difficult because of a lack of reliable clinical markers, Dr. Amy Murtha said at the annual meeting of the Infectious Diseases Society for Obstetrics and Gynecology.

Previous studies have shown that levels of the cytokines interleukin 6, interleukin 8, and granulocyte colony-stimulating factor (G-GSF) are elevated in the amniotic fluid and cervical secretions of women with intrauterine infection, compared with those without infection, said Dr. Murtha of Duke University Durham, N.C.

She and her colleagues had previously demonstrated that levels of maternal serum interleukin 6 increase before the onset of clinical evidence of infection in PPROM patients who subsequently develop funisitis.

In a study aimed at determining if interleukin 8 and G-CSF held the same predictive value, Dr. Murtha's team recruited patients who presented to the university hospital with PPROM at 22-34 weeks' gestation from July 1997 to November 2001.

Of the 82 presenting women, 29 remained undelivered for at least 48 hours without clinical indications of infection or labor and had daily maternal serum samples drawn for analysis of the two cytokines. Histology specimens were examined by a single pathologist for evidence of funisitis and ...