Interleukin-6 in amniotic fluid obtained at forewater amniotomy compared with hindwater samples in women in

K S Oláh1, J P Neilson, P M Johnson

  • 1Department of Obstetrics & Gynaecology, Liverpool University, UK.

Using an aseptic technique, samples of amniotic fluid were obtained from the forewaters and hindwaters of fifteen women in spontaneous labour with a deeply engaged fetal head. Prior to sampling, a cervical swab was obtained to exclude infection and in 10 cases samples of amniotic fluid were sent for microscopy and culture. Forewater samples were obtained using a pudendal block needle. Hindwater samples were obtained after membrane rupture by inserting an intra-uterine pressure catheter. Batch assay for interleukin-6 (IL-6) concentrations was performed using a specific ELISA. The levels of IL-6 in forewater samples of amniotic fluid were significantly higher than those found in hindwater samples (t = 3.65, P < 0.002). This suggests that either the production of IL-6 as a result of stimulation by its cytokine 'effectors' is greater at this site, or that the loss or metabolism of IL-6 in the forewaters is less than that in the hindwaters. The concentration of IL-6 parallels the reported levels of PGE2, and it is therefore likely that if IL-6 is involved in the mechanism of labour it acts through the effects of the resultant PGE2 release.