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Objective: To determine if maternal serum interleukin-6 (IL-6) levels remain predictive of funisitis after completion of antibiotic administration in preterm premature rupture of membranes (PPROM). Methods: A secondary analysis of a prospective cohort study. Daily blood samples obtained from PPROM subjects were analyzed for IL-6 by enzyme-linked immunosorbent assay. Subjects ( N = 39) delivered >7days post admission and were divided into those with and without funisitis. Data were analyzed using Mann-Whitney U test. Results: Maternal serum IL-6 levels obtained 24-48 hours and 48-72 hours before delivery are elevated in PPROM subjects with funisitis compared to those without funisitis (6.3 vs. 2.7 pg/ml, P < 0.03; 6.1 vs. 1.7 pg/ml, P < 0.02). Receiver operator characteristic curve revealed an IL-6 level of 1.98 pg/ml had sensitivity of 86.7%, specificity of 46.7%, positive predictive value of 61.9% and negative predictive value of 77.8%. Conclusion: This data suggests that maternal serum IL-6 levels continue to be predictive of PPROM subjects destined to develop funisitis after completion of antibiotics. [ABSTRACT FROM AUTHOR]

Objective: To evaluate cervical ripening with foley balloon combined with a fixed vs. incremental low-dose oxytocin infusion. Methods: Women presenting for term labor induction were randomized to fixed low-dose or standard incremental low-dose oxytocin infusion following foley balloon placement. The primary outcome was time from foley balloon placement to delivery. Results: Among 116 subjects, there was no difference in median time to delivery among subjects receiving fixed low-dose vs. standard incremental low-dose oxytocin during induction of labor with a foley balloon (23.7 vs. 19.2 hours). There were no differences between the two groups in median time to foley bulb extrusion, active labor and second stage of labor or incidence of uterine tachysystole, fetal heart rate abnormalities, mode of delivery or maternal hemorrhage. Conclusions: There is no difference in median time to delivery in women undergoing cervical ripening with a foley balloon combined with a fixed low-dose or standard incremental low-dose oxytocin. [ABSTRACT FROM AUTHOR]

Problem: Several lines of evidence have shown that maternal cytokine levels of tumor necrosis factor-alpha (TNF-alpha), interleukin (IL)-6, IL-8, and IL-10 were altered in women with pre-eclampsia (PE) compared to those from normal pregnancies. In this study, we determined whether these cytokine levels are correlated before and after delivery in patients with PE., Method of Study: Venous blood was obtained from 50 women diagnosed with severe PE at the time of admission and 24 hr after delivery. Plasma concentrations for TNF-alpha, IL-6, IL-8, and IL-10 were measured by ELISA., Results: There were no statistical differences for maternal levels of TNF-alpha, IL-6, IL-8, and IL-10 before and 24 hr postpartum. TNF-alpha and IL-10, but not IL-6 and IL-8, levels were significantly correlated before and 24 hr after delivery: TNF-alpha: y = 19.963 + 0.953*x; r(2) = 0.924; IL-10: y = 10.521 + 1.113*x; r(2) = 0.984, P < 0.001, respectively. Furthermore, TNF-alpha levels were correlated with IL-10 levels, but not with IL-6 and IL-8 levels., Conclusion: The correlation patterns of TNF-alpha with IL-10 and TNF-alpha with IL-6 and IL-8 suggest disparity in functional regulations between these cytokines in maternal circulation in PE.