الفهرس 
Anatomy of Fetomaternal InterfaceOnly 14 pages are availabe for public view
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Abstract
Preterm birth is defined as the onset of labor after the gestation of viability (20–28 weeks) and before 37 completed weeks, however it is a major challenge in perinatal health care, as it accounts for 35% of all neonatal deaths worldwide due to its short term and long term complications.
The overall rate of preterm birth has increased over the last few years, the exact etiology of preterm birth is often unknown, and many researches found that the etiology of Preterm birth is multifactorial, however there is strong association between preterm birth, infection and non infectious inflammatory preterm birth that contribute to premature initiation of parturitional cascade and imbalance between proinflammatory cytokine (IL-6) and anti- inflammatory cytokine(IL-10), so there is growing efforts in the identification of markers that may facilitate prediction and prevention of preterm birth complications, however noninvasive measurements of maternal serum cytokines concentrations is preferred over invasive measurements of maternal cytokines concentrations via amniocentesis.
This study was conducted at Ain Shams University Maternity Hospital from January 2013 to October 2013. After informed written consent which was obtained from each participant prior to inclusion in the study.
The aim of this study was to evaluate the accuracy of IL6 and IL10 in prediction of preterm birth.
This study included ninety three patients presented with threatened PTB.Their gestational age ranged from 30 weeks to less than 35 weeks, only singleton pregnancies included in the study, their ages ranged between 20 to 35 years, and BMI ranged from 20 to 24 kg per m2.
On admission, every patient was subjected to detailed history with exclusion of patients with Chronic diseases (e.g., hypertension, diabetes, renal or cardiac diseases), uncertain gestational age, previous spontaneous abortion, history of urinary infection in current pregnancy, rupture of membranes, history of pregnancy loss, uterine anomalies, previous caesarean section, also all patients were subjected to clinical examination, investigations including CBC, CUA, ultrasound, CRP, serum IL-6 and IL-10, before giving any treatment, all patients were followed up to detect those who delivered within 7 daysand those who delivered after 7 days.
Regarding to the results of this study pregnant women who delivered within 7 days had a higher level of serum IL-6 than those delivered after 7 days, as the cut off value of serum IL6 was ≥2.89 pg/ml in women with PTB who delivered within 7 days with 100% sensitivity, 100% specificity, 100% PPV, 100% NPP, however there was statistically significant difference between IL-6, BMI, GA, and cervical changes on admission, while there were no statistically significant difference between IL-6, age of the patient and parity.
IL-10 had a paradoxical action as it can act as anti- inflammatory or inflammatory cytokine according to its cut off level, as this study found that IL-10 with cutoff ≥ 5.49 pg/ml has inflammatory action, with 100% sensitivity, 96.1% specificity, 94.9% PPV, 100% NPV.As pregnant women with serum IL10 ≥ 5.49 pg/ml delivered within 7 days while those with level < 5.49 pg/ml delivered after 7 days. Same as IL-6 there was statistically significant difference between IL-10, BMI, GA, and cervical changes on admission, while there were no statistically significant difference between IL-10, age of the patient and parity.
In this study we found that when the maternal serum level of IL-6 ≥ 2.89 pg/ml and/or the maternal serum level of IL-10≥ 5.49 pg/ml, there was a high possibility of BTB within one week.
So we can conclude that the maternal serum level of IL-6 and, or IL-10 had a role in timing the date of delivery, so both can be used as non invasive method for prediction of PTB.
This statement needs more studies to be a dependent method for prediction of PTB.