Maternal Plasma Lipopolysaccharide Binding Protein And IL-6 Concentrations In Pregnancy Complicated By Premature Rupture Of Membranes

Objectives: The aim of this study is to explore whether LBP concentrations are of value in the diagnosis of subclinical intra-amniotic infection(IAI), and in the treatment of PROM, by investigating and comparing maternal plasma IL-6 and LBP concentrations in pregnancies complicated by premature rupture of membranes(PROM).Material and methods: Subjects were selected from the department of gynaecology and obstetrics in our hospital. Thirty patients with pPROM, 30 with PROM at term and 30 healthy women at term were included. Analysis of maternal plasma LBP and IL-6 concentrations was conducted by the means of elisa technique. Fetal membrane samples were collected. HE staining was also used for morphology and infection observation. Statistical analysis was performed with SPSS15.0 software.Results:1. HE staining: subclinical intra-amniotic infection can be investigated in all the groups. There was a significant difference in the incidence of IAI between PROM group and normal control group(X2=9.289, P=0.002<0.05). The infection rate of pPROM group was slightly higher than that of tPROM, While the difference was not statistically significant(X2=0.057, P=0.812>0.05).2. ELISA: In pPROM group, tPROM group and normal term pregnancy group, plasma IL-6 concentrations were(14.61 + 66.14) ug/ml,(61.34 + 12.56) ug/ml,(44.72 + 16.94) ug/ml. LBP level were( 125.22±37.51) ug/ml 、( 102.87±20.90) ug/ml 、(66.09±31.17)ug/ml. There were significant differences in IL-6 among the three groups(P<0.05), while the tPROM group was slightly higher than pPROM group, but the difference was not statistically significant(P>0.05). There was significant difference in LBP level among the three groups(P<0.05). The LBP level in pPROM group was significantly higher than that of the pPROM group(P<0.05).3. Correlation: serum LBP concentration and the degree of inflammation of the chorionic membrane is significantly correlated(r=0.626, P=0.004). And there was no significant correlation between IL-6 concentration and inflammation(r=0.190,P=0.438). The concentration of serum IL-6 and LBP was increased with the period of the rupture of membrane(P<0.05).ConclusionsThe predictive value of maternal LBP and IL-6 determinations in the diagnostics of pPROM cases suspected of IAI is satisfactory. The serum levels of IL-6 and LBP can be helpful to determine the timing of rupture of membranes and the degree of inflammation.