The comparison of amniotic fluid nuclearfactor-kappa B levels in pregnant women who underwent cesarean section or normal vaginal labor

Abstract

Objective Inflammatory changes in the amniotic membranes during prenatal period have a critical important in the rupture of membranes and the onset of labor. The inflammatory changes in the membranes caused by normal vaginal labors and cesarean sections (C/S) are different than each other. Nuclear factor-kappa B (Nf- kB) is the basic cellular marker of the inflammation change in biological fluids and tissues. We planned this study to compare amniotic fluid NF-kB (AF-NF-kB) concentrations in normal vaginal labor cases and those who underwent non-emergency C/S. Methods One-hundred singleton term pregnant women who did not have any serious fetal and maternal problems were included in the study. The pregnant women were separated into two groups, which contained 50 cases each. The week of gestation was calculated according to the last menstrual period and ultrasonography measurements. The groups included 50 patients who did not have the history of clinical chorioamnionitis and preterm premature rupture of membranes and were decided to have normal vaginal labor, and 50 term pregnant women who were decided to have cesarean section due to maternal or perinatal reasons. The amniotic fluid samples were collected during cesarean section or normal vaginal labor. After opening the membranes by scalpel in C/S cases and following spontaneous or artificial membrane rupture in vaginal labor cases, the amniotic fluid samples were collected. AF-NF-kB concentrations were evaluated by ELISA method. Results AF-NF-kB levels of the patients in the group of normal vaginal labor were significantly higher than AF-NF-kB levels of the patients in C/S group. AF-NF-kB levels were about 2 times higher in the group of normal vaginal labor (1.44±0.40 ng/ mL vs. 0.71±2.60 ng/mL, p<0.001). There was a positive but insignificant correlation between the fetal birth weight and AF-NF-kB levels in the patients who underwent normal vaginal labor. There was no significant correlation between AF-NF-kB levels and demographic and clinical characteristics of the patients who underwent labor by C/S. Conclusion Normal vaginal labor is associated with the increased AF-NF-kB concentrations compared to C/S cases. AF-NF-kB levels seem to be a potential predictor for the spontaneous fetal membrane rupture.