Agus Abadi, - (1999) Keradangan Selaput Ketuban, Plasenta Dan Interleukin-6 Sebagai Faktor Penentu Terjadinya Persalinan Pada Persalinan Kurang Bulan Membakat(Studi kohort dengan pendekatan imuno-endokrinologi. Disertasi thesis, Universitas Airlangga.

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Abstract

In the past decade, there had been mounting evidence of a link between infection and preterm labour. The role of inflamation of the amniotic membrane, placenta and amniotic fluid inflamatory cytokines on the patophysiology of preterm labour, are a center of appreciation. In case of effective and rational management of preterm labour, it is important to find out the high predictive value of clinical and biochemical markers. The observasional analitic kohort study has been conducted on cases of preterm labour with intact membrane. The objectives of this study are (I) to prove the role of inflamation of the amniotic membrane, placenta and amniotic fluid inflamatory cytokines on preterm labour, (2) to know the relationship between microbial invasion in the amniotic cavirty and the incidence of peterm labour, (3) to find out clinical and biochemical markers to predict preterm delivery in case of preterm labour. Fifty cases of preterm labour with intact membrane has been observed until the delivery of the baby. Amniocentesis were performed antenatally and amniotic fluid inflamatory cytokines (IL-l {3, IL-6, IL-8 and TNF-a) were determined quantitatively by Elisa (Milenia, Endpoint Enzyme Immunometric Assay). Amniotic fluid culture for aerobe and anaerobe had been performed and the criteria of positive culture were I 00 coloni forming unit (cfu) per mililiter amniotic fluid . Amniotic membranes and placentas were taken postnatally to evaluate histopatological sign of inflamation, appropriate with the criterion of Salatia (Salatia 1989). The result of this study are, ( 1) the inflamation of amniotic membranes, placentas and amniotic fluid IL-6, present a significant risk for preterm delivery in case of preterm labour with intact membrane, (2) the higher the grade of inflamation, the higher the possibility to be preterm delivery, (3) microbial invasion in amniotic cavity has no relationship with preterm delivery but there is a positive correlation with the histopatological inflamation of amniotic membranes, placentas and amniotic fluid inflamatory cytokines (IL-1Jl, IL-6, IL-8, TNF-a), (4) IL-6 is the most significant single biochemical marker to predict preterm delivery in case of preterm labour with intact mambrane, (5) a marker consist of two or more parameters of IL-6, uterine contraction, effacement and maternal leukocytes present higher predictive value than single marker to predict preterm delivery

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