[Intercellular adhesion molecular 1, a diagnostic serum marker in chorioamnionitis, pre-eclampsia and HELLP syndrome]

Chorioamnionitis and pregnancy-induced hypertension both are extremely feared complications of human pregnancy. Activation or disturbance of normal endothelial cell function may be involved in the pathogenesis of both kinds of disease. The aim of our study was to compare the diagnostic value of soluble intercellular-adhesion-molecule-1 (ICAM-1) with that of C-reactive protein (CRP) and white blood cell count for the detection of chorioamnionitis in patients with preterm labor. In addition, we examined if concentrations of ICAM-1 were also increased in case of preeclampsia or HELLP-syndrome.

ICAM-1, CRP and leucocyte count were estimated in 50 cases of normal term delivery, 97 cases of uncontrollable preterm labor, 16 cases of preeclampsia and 9 cases of HELLP-syndrome before delivery.

From 97 women delivering preterm, chorioamnionitis was histologically confirmed for 48 women. Maternal serum levels of ICAM-1 (p < 0.001), CRP (p < 0.001) and leucocyte count (p < 0.02) were significantly higher in the group of preterm delivering patients (< 37 weeks gestation) with histologically confirmed chorioamnionitis in comparison to preterm delivering patients in the absence of chorioamnionitis. In the group of patients delivering preterm (< 37 weeks gestation) because of preeclampsia or HELLP-syndrome, ICAM-1 (p < 0.001), as well as CRP (p < 0.006) concentrations were also significantly increased in comparison to patients delivering preterm in the absence of chorioamnionitis.

Elevated levels of ICAM-1 in the serum of pregnant women may be considered as an important risk factor for the development of complications in pregnancy associated with inflammatory induced changes of maternal endothelial cell functions.