Correlation Analysis Of Serum IL-6 And TNF-α With Chorioamnionitis In Pregnant Women With Premature Rupture Of Membranes

Objective: To correlation analysis the levels of IL-6 and TNF-α with the premature rupture of membranes complicated with chorioamnionitis by detecting the peripheral blood of pregnant women.Methods: Selected 150 cases of pregnant women who were hospitalized for delivery in Inner Mongolia Maternal and Child Health Care Hospital from December 2019 to December 2020.These patients were divided into experimental group and control group.The experimental group included 120 maternal with premature rupture of menbranes(the time of rupture of membranes in all patients was less than 12 hours).The experimental group was divided into clinical chorioamnionitis group,subclinical chorioamnionitis group and non-chorioamnionitis group according to the patient’s clinical manifestations and placental pathological results.The 30 cases of full term normal delivery maternity were selected as the control group which 5ml of peripheral venous blood was extracted at admission,while in the experimental group,5ml of peripheral venous blood was extracted at admission and delivery(prenatal fever).Serum fluid was centrifuged and stored at-70℃ refrigerator for reserve.The concentration of serum IL-6 and TNF-α in each group were determined by ELISA.The 2.0cm×2.0cm×2.0cm tissue samples were taken from the center or edge of the placenta after postpartum.Blood stains and amniotic fluid were washed by normal saline,fixed with formaldehyde,using the routine method of paraffin wax embed and stored for pathological examination.Results:1.There was no statistically significant difference in age,gestational age,gravida,para between the experimental group and the control group(P>0.05);The serum levels of IL-6 and TNF-α in the experimental group were higher than the control group on admission was statistically significant(P<0.05).2.In the experimental group,the serum levels of IL-6 and TNF-α in pregnant women with chorioamnionitis group were higher than combined with subclinical chorioamnionitis group were statistically significant difference(P<0.05);Serum levels of IL-6 and TNF-α in pregnant women with subclinical chorioamnionitis group were higher than non-chorioamnionitis group,the differences were significant(P<0.05);Pairwise comparison the time of membrane rupture between experimental groups,the time of chorioamnionitis group was significantly longer than non-chorioamnionitis group,the levels of IL-6 and TNF-α in the peripheral blood increased with the prolongation of membrane rupture time in maternal,the differences were significant(P<0.05).3.The ROC curve(AUC)showed that the area under curve of IL-6 and TNF-α were 0.895 and 0.790,the 95% confidence intervals were(0.788-0.959)and(0.665-0.884),the sensitivity was 93.94% and 48.48%,the specificity was 70.37% and 96.30%.The area under the ROC curve(AUC)of the combined detection of the two makers was 0.901,the 95% confidence interval was(0.796-0.963),the sensitivity was 87.88%,the specificity was 81.48%.Conclusions:1.The levels of IL-6 and TNF-α in the peripheral blood of pregnant and parturient women are closely related to the occurrence and development of premature rupture of membranes.2.There is an increased risk of intra-amniotic infection with the levels of IL-6 and TNF-α in peripheral blood rised in pregnant women when the prolongation of time of premature rupture of membranes.3.The combined detection of IL-6 and TNF-α in peripheral blood serum of pregnant and parturient women after premature rupture of membranes can improve predict value of the chorioamnionitis.It is paly an indispensable role in clinical significance for early detection,diagnosis and treatment of chorioamnionitis.