[Finding a developing intrauterine infection in preterm birth by using classic and modern infection indices]

A significant part of preterm births (PTB) are due to a developing intrauterine infection (IUI). This infection is often of subclinical nature, and its diagnosis is mainly based on laboratory measurements. The objective of our study was to compare the diagnostic potential of classic (clinical picture, leukocyte count, CRP) and modern (IL-6) indices of an infectious and inflammatory process. We found the established clinical symptoms of IUI in 4.2% of the women with PTB, and if symptoms such as subfebrile body temperature (37'-37.5 degrees C), and mother's pulse of 90-100 beats/minute are taken into consideration, then with them this infection were diagnosed 23% of the women with PTB. Based on reference values of blood markers, the following incidence rates of infection were established for the studied pregnant women: increased Leu--26.7% for PTB, and 3% for the full-term birth group; based on increased CRP--51.7% for PTB, and no available data on infection for the control group; based on IL-6 over 11 pg/ml--66.7% for the PTB group, and 16.7% for the full-term women. Laboratory markers have the following sensitivity, specificity and accuracy in finding an intrauterine infection (histologically confirmed): for Leu--93.3%, 25%, and 47.8%, respectively; for CRP--100%, 53.4%, and 69.3%; and IL-6--90%, 70%, and 76.7%, respectively. Obtained results demonstrate that clinical symptoms are rarely indicative of IUI. Of all laboratory measurements, IL-6 has the best diagnostic profile, followed by CRP and leukocyte count.