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Upregulated Amniotic Fluid Cytokines and Chemokines in Emergency Cerclage with Protruding Membranes

Authors

  • Joon-Cheol Park,

    1. Department of Obstetrics and Gynecology, School of Medicine, Keimyung University, Daegu, Korea
    2. Reproductive Medicine, Department of Obstetrics and Gynecology, The Chicago Medical School at Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA
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  • Dong-Ja Kim,

    1. Reproductive Medicine, Department of Obstetrics and Gynecology, The Chicago Medical School at Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA
    2. Department of Pathology, The Chicago Medical School at Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA
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  • Joanne Kwak-kim

    1. Reproductive Medicine, Department of Obstetrics and Gynecology, The Chicago Medical School at Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA
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  • The serum CRP on postoperative day 3, day 7, and the amniotic fluid IL-1α, IL-1β, IL-8 were significantly associated with poor prognosis of fetal survival.

Joon-Cheol Park, Reproductive Medicine, Department of Obstetrics and Gynecology, The Chicago Medical School at Rosalind Franklin University of Medicine and Science, 830 West End Court, Suite 400, Vernon Hills, IL 60061, USA.
E-mail: jcpark@dsmc.or.kr

Abstract

Citation Park J-C, Kim D-J, Kwak-Kim J. Upregulated amniotic fluid cytokines and chemokines in emergency cerclage with protruding membranes. Am J Reprod Immunol 2011; 66: 310–319

Problem  To identify the prognostic factors for pregnancy outcome in women who received emergency cerclage for dilated cervix with protruding membranes.

Method of study  A prospective cohort study was performed, and a total of 14 women who received emergency cerclage were included. Clinical features and laboratory findings including amniotic fluid cytokines and chemokines were compared between women who had successful pregnancy (survival group, n = 6) and those who had perinatal death (non-survival group, n = 8). Five healthy pregnant women served for normal controls for amniotic fluid study.

Results  The overall neonatal survival was 42.9% in women with emergency cerclage. Serum C-reactive protein levels on postoperative day 3 and 7 were significantly higher in non-survival group when compared with those in survival group (P = 0.002, P = 0.01). Amniotic fluid levels of interleukin (IL)-1α, IL-1β, IL-6, IL-8, IL-10, tumor necrosis factor-α, and monocyte chemoattractant protein-1 levels of the patients were significantly higher than those of normal controls. Amniotic fluid levels of IL-1α, IL-1β, and IL-8 were significantly increased in the non-survival group when compared with those of the survival group.

Conclusion  Systemic and local inflammatory markers including proinflammatory cytokines and chemokines may predict pregnancy outcome in women with emergency cerclage for dilated cervix with protruding membranes.

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