Predictive Value of First Amniotic Sac IL-6 and Maternal Blood CRP for Emergency Cerclage Success in Twin Pregnancies.

Fecha de publicación: 19/01/2025

Autores de IIS La Fe

Alicia Martínez Varea

Autor
Ricardo Miguel Alonso Díaz

Autor
Alfredo José Perales Marín

Autor
Vicente Jose Diago Almela

Autor

Participantes ajenos a IIS La Fe

Diago-Munoz, Diana Maria

Grupos

Infecciones Respiratorias

Investigador Principal

Raúl Méndez Ocaña
Medicina Reproductiva

Investigador Principal

José Morales Roselló
Salud Cardiovascular Materna, Preeclampsia y Parto Prematuro

Investigador Principal

Beatriz Marcos Puig

Abstract

Objectives: To assess the usefulness of first amniotic sac Interleukin-6 (IL-6) to rule out intra-amniotic inflammation (IAI), as well as maternal blood c-reactive protein (CRP), to select patients with a twin pregnancy who may benefit from an emergency cerclage. Materials and Methods: Retrospective, descriptive study among all patients with a twin pregnancy and mid-trimester bulging membranes admitted to a tertiary Hospital from January 2012 to September 2023. According to the Hospital's Protocol, all patients received a vaginal and abdominal ultrasound, a maternal blood test, and an amniocentesis of the first sac to rule out IAI, defined by IL-6 = 2.6 ng/dL. Results: A total of 28 patients with a twin pregnancy and mid-trimester bulging membranes were included. Among them, 18 patients (64.28%) had IL-6 levels = 2.6 ng/dL. Cerclage was placed in 10 patients with IL-6 < 2.6 ng/dL. Perinatal mortality in pregnancies with IL-6 = 2.6 ng/dL was 77.22%. The gestational age at delivery of patients with IL-6 < 2.6 ng/dL was 34 ± 3 weeks, compared to 23 ± 4 weeks when IL-6 was =2.6 ng/dL (p < 0.001). The latency to delivery with IL-6 < 2.6 ng/dL was 88.1 ±31.56 days, compared to 13.11 ± 20.43 days when IL-6 was =2.6 ng/dL (p < 0.001). Significant differences were found in maternal blood CRP levels in both study groups (no IAI 4.32 ± 3.67 vs. IAI 13.32 ± 15.07, p < 0.05). The area under the curve with an ROC curve was 0.799 (IC 95% 0.596-0.929), with a cut-off of 3.9 mg/L (S 94.4%, % E 62.5%). The gestational age at delivery with CRP < 3.9 mg/L was 33 ± 5 weeks, while in cases with CRP = 3.9 mg/L, it was 24 ± 5 weeks (p < 0.001). The latency days to delivery were 86.5 ± 44.88 and 21.95 ± 30.97 days (p < 0.01), respectively. A positive correlation between the IL-6 values of both amniotic sacs was obtained, along with the Spearman coefficient correlation rank (rho = 0.835, p < 0.001). Conclusions: Compared to those with IAI, patients with a twin pregnancy and mid-trimester bulging membranes without IAI who underwent emergency cerclage had a significantly higher interval from diagnosis to delivery, as well as a significantly lower incidence of preterm birth < 34 weeks and perinatal death. Further studies are needed to assess whether the IL-6 of the first amniotic sac and maternal blood CRP might constitute a useful parameter to select patients who may benefit from an emergency cerclage.

Datos de la publicación

ISSN/ISSNe:: 2075-4426, 2075-4426
Tipo:: Article
Páginas:: -
DOI:: 10.3390/jpm15010037
Factor de Impacto:: 0,757 SCImago ℠
Cuartil:: Q2 SCImago ℠

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APLICACION DE TECNICAS LAPLACIANAS PARA LA MONITORIZACION DE LA ACTIVIDAD ELECTRICA DEL MUSCULO LISO HUMANO:ENFASIS EN ELECTROHISTEROGRAMA (LAMOHIS)

Investigador Principal: ALFREDO JOSÉ PERALES MARÍN

LAMOHIS PLAN NACIONAL I+D+I 2008-2011 . 2010

UTILIDAD DEL TRATAMIENTO TOCOLITICO DE MANTENIMIENTO EN EL MANEJO DE LA AMENAZA DE PARTO PREMATURO (APP)

Investigador Principal: MÁXIMO VENTO TORRES

EC11-246 . 2012

BIOMARCADORES INFLAMATORIOS Y CARDÍACOS COMO PREDICTORES DE EVENTOS CARDIOVASCULARES Y MORTALIDAD TRAS EL ALTA EN LA NEUMONÍA ADQUIRIDA EN LA COMUNIDAD.

Investigador Principal: ROSARIO MENÉNDEZ VILLANUEVA

PI13/00583 . INSTITUTO DE SALUD CARLOS III . 2014

CON-CIENCIA-YV: PILDORAS DE SALUD

FCT-13-7457_FECYT_2013 . MINISTERIO DE ECONOMIA Y COMPETITIVIDAD; FUNDACIÓN PARA LA INVESTIGACIÓN DEL HOSPITAL UNIVERSITARIO LA FE DE LA COMUNIDAD VALENCIANA . 2013