Relationship of IL-6 and IL-8 levels with tubal ectopic pregnancy
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20234075Keywords:
Ectopic, IL-6, IL-8, Levels, Pregnancy, Relationship, TubalAbstract
Background: The frequency of ectopic pregnancy (EP) has increased worldwide during the last 30 years, particularly in underdeveloped countries with low early diagnostic rates. Ectopic pregnancy is the major cause of first-trimester deaths. Interleukins are immunomodulatory cytokines that modulate inflammatory responses and help humans conceive. Aim of the study was to evaluate the predictive value of interleukin-6 and interleukin-8 in tubal ectopic pregnancy.
Methods: This case control research was undertaken in the Department of Obstetrics and Gynaecology at Al-Emamein Al-Kadhemein Medical City/Baghdad from January 1, 2022 to January 1, 2023. The study analysed 30 patients with missed cycles, positive β-HCG tests, vaginal bleeding, and ruptured tubal ectopic pregnancy diagnosed via transvaginal ultrasound (group A) and 30 patients with intrauterine missed miscarriage (group B). The control group (group C) included 30 ladies with uncomplicated intrauterine pregnancies of matched gestational age.
Results: Interleukin-6 was substantially greater in ectopic pregnancy than miscarriage and normal intrauterine pregnancy. Ectopic pregnancy and miscarriage had higher levels of interleukin-8 than normal intrauterine pregnancy, but there was no difference. Interleukin-6 levels ≥76.1 pg/ml were linked to 90% sensitivity and 85% specificity in predicting ectopic pregnancy. Interleukin-8 was neither sensitive nor specific for ectopic pregnancy.
Conclusions: Measurement of IL-6 may have a predictive value in cases of ruptured tubal ectopic pregnancy. IL-8 was a poor predictor for ectopic pregnancy.
References
Ectopic Pregnancy. In: Cunningham FG, Leveno KJ, Dashe JS, Hoffman BL, Catherine YS, Casey BM, editors. Williams obstetrics. 26th ed. New York, USA: McGraw Hill; 2022:549-89.
Gerema U, Alemayehu T, Chane G, Desta D, Diriba A. Determinants of ectopic pregnancy among pregnant women attending referral hospitals in southwestern part of Oromia regional state, Southwest Ethiopia: a multi-center case control study. BMC Pregn Childb. 2021;21(1).
World Health Organization. Reproductive health strategy to accelerate progress towards the attainment of international development goals and targets, 2004. Available at: https://www.who.int/publications/i/ item/WHO-RHR-04.8. Accessed on October 1 2023.
American College of Obstetricians and Gynecologists. ACOG Practice Bulletin No. 193: tubal ectopic pregnancy. Obstetr Gynecol. 2018;131(3):e91-103.
Yeasmin MS, Uddin MJ, Hasan E. A clinical study of ectopic pregnancies in a tertiary care hospital of Chittagong, Bangladesh. Chattagram Maa-O- Shishu Hosp Medi Coll J. 2014;13(3):1-4.
Benaliwa E, Morgham A, Osman N, Ali F, Almahdi L, Othman H, et al. Ectopic Pregnancy: incidence, associated risk factors and complications from Yashfeen Clinic. AlQalam J Med Appl Sci. 2022:447-53.
Ectopic pregnancy. In: Podder L, editor. Fundamentals of Midwifery and Obstetrical Nursing. 1st ed. New Delhi, India: Elsevier Health Sciences; 2019:217-9.
Greenspan PB. Obstetrical Etiologies of Abdominal Pain. The Diagnosis and Management of the Acute Abdomen in Pregnancy. 2018:107-40.
Leonardi M, Allison E, Lu C, Nadim B, Condous G. Prognostic accuracy of a novel methotrexate protocol for the resolution of tubal ectopic pregnancies. Euro J Obstetr Gynecol Reproduct Biol. 2020;247:186-90.
Ma L, Li Z, Xi S, Guo Q, Zhao P, Li W, et al. Tubal ectopic pregnancy occurrence is associated with high expressions of prokineticin receptors and aberrant secretion of inflammatory cytokines. Am J Transl Res. 2020;12(9):5741-51.
Rajendiran S, Senthil Kumar G, Nimesh A, Dhiman P, Shivaraman K, Soundararaghavan S. Diagnostic significance of IL-6 and IL-8 in tubal ectopic pregnancy. J Obstetr Gynaecol. 2016;36(7):909-11.
Tsakiridis I, Giouleka S, Mamopoulos A, Athanasiadis A, Dagklis T. Diagnosis and management of ectopic pregnancy: a comparative review of major national guidelines. Obstetr Gynecol Surv. 2020;75(10):611-23.
Moini A, Hosseini R, Jahangiri N, Shiva M, Akhoond MR. Risk factors for ectopic pregnancy: A case-control study. J Res Med Sci. 2014;19(9):844-9.
Gyamtsho S, Tenzin K, Choeda T, Lhaden K, Om T. Incidence and clinical profile of ectopic pregnancies in a tertiary hospital; A two-year retrospective study. Bhutan Heal J. 2020;6(2):6-11.
Rogne T, Liew Z, Hernáez Á, Brumpton BM, Magnus MC. Modifiable risk factors for ectopic pregnancy: a Mendelian randomization study. Am J Obstetr Gynecol. 2022;227(2):339-41.e4.
Essa S, Ghafel H. Correlation between Ectopic Pregnancy and Reproductive History among Pregnant Women in Karbala City/ Iraq. Kufa J Nurs Sci. 2021;11(1):1-7.
Tufail N, Ansar A, Latif A, Mirza TI, Butt MQ, Ahmed S. Ectopic pregnancy-presentation and management at Allama Iqbal Memorial Teaching Hospital Sialkot. Diabetes. 2021;126:18.69.
Heaton HA. Ectopic pregnancy and emergencies in the first 20 weeks of pregnancy. Tintinalli’s emergency medicine: a comprehensive study guide 8th ed. New York: McGraw Hill. 2016:628-36.
Hadi C, Budiman J, Prasetyo A, Pramana C. The Role of Interleukin in Ectopic Pregnancy: A Systematic Review. Macedon J Med Sci. 2021;9(F):238-45.
Balasubramaniam ES, Van Noorden S, El-Bahrawy M. The expression of interleukin (IL)-6, IL-8, and their receptors in fallopian tubes with ectopic tubal gestation. Fertil Steril. 2012;98(4):898-904.
De Ramón Fernández A, Ruiz Fernández D, Prieto Sánchez MT. A decision support system for predicting the treatment of ectopic pregnancies. Int J Medi Inform. 2019;129:198-204.
