Background: In previous studies a significant increase in interleukin (IL)-6 and IL-8 concentrations in the lower uterine segment parallel to cervical dilatation at term could be found, however only a weak correlation to duration of labor was detected. This study compares amniotic fluid concentrations of interleukin (IL)-6 and IL-8 with those in the lower uterine segment, and the duration of labor.
Methods: Amniotic fluid and lower uterine segment specimens were obtained from 29 patients during cesarean section at term. The patients were divided into groups according to cervical dilatation (< 2 cm, 2-3.9 cm, 4-6 cm, > 6 cm) and to labor (0 h, > 0-12 h, > 12 h). Interleukin-6 and IL-8 concentrations were determined by enzyme immunoassay.
Results: Amniotic fluid IL-6 already increased at 2-3.9 cm (p = 0.02), while the steepest increase in IL-8 was observed at > 6 cm (p = 0.003). No correlation with lower uterine segment values was observed for either of the cytokines. However, the amniotic fluid IL-6 concentration correlated with labor (p = 0.0008).
Conclusion: The increase in the concentration of IL-6 in the amniotic fluid earlier than its increase in the lower uterine segment supports the hypothesis that IL-6 plays a crucial role for the promotion of labor in the first place, and afterwards for the biochemical degradation processes in the lower uterine segment. The fact that the greatest increase in IL-8 concentration occurs only at > 6 cm indicates that this chemotactic cytokine has only minor significance in the initiation of parturition by its concentration in the amniotic fluid.