American Journal of Obstetrics and Gynecology
Elevated amniotic fluid interleukin-6 levels at genetic amniocentesis predict subsequent pregnancy loss☆,☆☆,★,★★
Section snippets
MATERIAL AND METHODS
We accessed our bank of stored second-trimester amniotic fluid and maternal serum obtained from all women undergoing genetic amniocentesis at our institution from 1988 to 1995 (N = 11,971). All amniocenteses were performed by an experienced operator using a 22-gauge spinal needle and ultrasonographic guidance. All maternal serum was obtained just before the procedure as part of a larger, institutional review board - approved study of the multiple marker screening test. Every sample was stored
RESULTS
The overall unexplained postamniocentesis pregnancy loss rate was 0.55% (66/11,971). The mean maternal serum IL-6 levels were similar in cases and controls (0.02 ± 0.07 ng/ml in cases and 0.06 ± 0.25 ng/ml in controls, p = 0.45). However, mean amniotic fluid IL-6 levels were higher in cases (4.0 ± 13.1 ng/ml in cases and 0.5 ± 0.7 ng/ml in controls, p = 0.04). The highest amniotic fluid IL-6 levels tended to occur in cases with the earliest loss (<7 days, 8.9 ± 19.6 ng/ml; 7 to 13 days, 4.5 ±
COMMENT
In the >30 years since second-trimester genetic amniocentesis was first described, numerous innovations in technique have improved the safety of the procedure. The procedure-related pregnancy loss rate is generally quoted as 0.5%, the same incidence observed in our study. Although low, this persistent miscarriage rate is frustrating to many clinicians who use the safest techniques and yet cannot seem to avoid this occasional complication.
One explanation for postamniocentesis pregnancy loss is
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Cited by (0)
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From the Center for Obstetric Research, Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology,aand the Department of Nutrition Sciences,bUniversity of Alabama at Birmingham.
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Supported in part by Agency for Health Care Policy Research contract No. 282-92-0055.
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Reprint requests: Katharine D. Wenstrom, MD, University of Alabama at Birmingham, Department of Obstetrics and Gynecology, 618 South 20th St., UAB Station, Birmingham, AL 35233-7333.
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