Diagnostic value of Chorioquick for detecting chorioamnionitis in women with premature rupture of membranes

Abstract

Objective To determine the accuracy of a semi‐quantitative interleukin‐6 (IL‐6) vaginal secretion rapid test (Chorioquick) for detecting chorioamnionitis in women with premature rupture of membranes (PROM). Methods A prospective cohort study in five tertiary hospitals in Nigeria involved women with confirmed PROM at term and preterm PROM with or without suspected chorioamnionitis from August 1, 2017, to October 31, 2018. Cervicovaginal fluid samples were tested for chorioamnionitis using the Chorioquick test. Samples were repeated at decision to deliver. The test was considered positive if at least the indicator ‘IL‐6 low’ of the three Chorioquick biomarkers (low, medium, high) was positive, or negative if none of the biomarkers were positive. Chorioamnionitis was histologically confirmed post‐delivery using three tissue samples. Primary outcome measures were sensitivity, specificity, and accuracy. Results Of 73 women, on histological confirmation, 39 were true positive and 29 were true negative (for chorioamnionitis) to the Chorioquick test at repeat assessment. Overall, the Chorioquick test had a sensitivity of 97.5% (95% confidence interval [CI] 85.3–99.9), specificity 87.9% (70.9–96.0), and accuracy 93.2% (79.5–99.1). Sub‐group analysis of women <37 weeks of pregnancy showed a sensitivity of 100.0% (95% CI 83.4–100.0), specificity of 91.3% (70.5–98.5), and accuracy of 95.8% (82.5–99.5). Triple positive samples were 100.0% specific in all gestations. Conclusion Chorioquick showed favorable utility for detecting chorioamnionitis in PROM and could be a reliable, non‐invasive rapid tool in a real‐world clinical setting.

Interleukin-6 bedside test in detecting chorioamnionitis in women with preterm premature rupture of fetal membranes

“…Participants were subjected to general, and abdominal examinations, abdominal ultrasound, sterile speculum examination for detection of AF pooling, and assess-ment of IL-6 in the cervico-vaginal secretions (CVS) using the non-invasive IL-6 bedside test (Chorioquick ® , Biosynex SA, Strasbourg, France) on admission [5]. During the conservative treatment, studied women received two doses dexamethasone [12 mg intramuscularly 12 hours apart (for induction of fetal lung maturity)], and antibiotics according to ACOG recommendations (intravenous ampicillin 2 g, and erythromycin 250 mg every 6 h for 48 h, followed by oral amoxicillin 250 mg, and erythromycin 333 mg every 8 h for 5 days).…”

“…IL-6 bedside test is a new IL-6 based test to detect chorioamnionitis and has the potential to detect IL-6 in CVS at three different thresholds [IL-6 low (0.1 ng/mL), IL-6 medium (0.25 ng/mL), and IL-6 high (5 ng/mL)] [5].…”

“…The preterm premature rupture of fetal membranes rupture (PPROM) is one of the common problems in obstetrics [1]. It occurs in approximately 3-5% of all pregnancies [2][3][4], and accounts for 30-40% of preterm deliveries (PTDs) [5]. About 30-80% of PTDs following PPROM are complicated by histological chorioamnionitis [5].…”

“…It occurs in approximately 3-5% of all pregnancies [2][3][4], and accounts for 30-40% of preterm deliveries (PTDs) [5]. About 30-80% of PTDs following PPROM are complicated by histological chorioamnionitis [5].…”

“…IL-6 bedside test is a new IL-6 based test with the potential to detect IL-6 at three different thresholds for diagnosing chorioamnionitis [5]. Therefore, this study designed to evaluate the accuracy of the IL-6 bedside test in detecting chorioamnionitis in women with PPROM.…”