Amniotic fluid cytokine profile in association with fetal hyperechogenic bowel

Fetal hyperechogenic bowel (FEB) is associated with infection, chromosomal abnormalities and poor fetal outcome. FEB may result from an intrauterine fetal bowel cytokine-mediated inflammatory response. Since alterations in the levels of the cytokines interleukin (IL)-6, IL-8, IL-10, tumour necrosis factor (TNF)-alpha and interferon (IFN)-gamma are associated with pregnancy complications and necrotizing enterocolitis, this study aimed: (i) to determine their involvement in the pathophysiology of FEB and (ii) to identify their role as amniotic fluid markers of this condition.

In this prospective case-control study, amniotic fluid was collected by transabdominal amniocentesis from pregnant women with fetuses presenting (n=10)--or not (n=30)--with FEB during routine 18-20 week ultrasound scans. Cell-free amniotic fluid samples were analysed for cytokine concentrations by fluid-phase multiplex immunoassay. Data were compared by Mann-Whitney U-tests and Pearson correlations.

Amniotic fluid IL-8 levels were significantly higher in the FEB group. There was a positive correlation between IL-6 and each of IL-8 and INF-gamma, as well as between IL-8 and IL-10, and TNF-alpha and INF-gamma.

FEB likely ensues from a fetal inflammatory process involving IL-8 and, possibly, IL-6 and IL-10. This indicates the potential of immunomodulatory therapy in the management of FEB.