ESTIMATION OF SERUM INTERLEUKIN 15 IN WOMEN WITH ECTOPIC PREGNANCY AND MISSED ABORTION IN COMPARISON WITH NORMAL PREGNANCY IN TIKRIT TEACHING HOSPITAL
Keywords:
ectopic pregnancy, failed pregnancy, missed abortion, IL-15.Abstract
This study aims to assess the role of IL-15 serum measurement at 6-8 weeks in identifying failed pregnancies, ectopic or missed abortions, and healthy intrauterine pregnancies. A case control study was conducted at Tikrit Teaching Hospital, involving 90 patients (Ectopic pregnancy (30 patient) and missed abortion (30 patient), and control (30 pregnant women without complication). Data was collected through questionnaires, ultrasound examinations, and serum samples. The study aims to improve the diagnostic accuracy of ectopic pregnancy.
The study found that the mean age of the missed abortion group was 26.78 ± 5.30, while the EP group had a mean age of 28.7 ± 6.2. The mean interleukin-15 levels were significantly higher in the EP group (65.5±14.42) pg/ml compared to the missed abortion group (33.21± 8.0) pg/ml, and control group (14.4± 4.12) pg/ml.
The receiver operating characteristic curve for diagnosing failed pregnancy and missed abortion determined the cut of value of 22.4 pg/ml as best area 99.8%, and 99.6% respectively. while for ectopic pregnancy was 29.55 pg/ml was the best area under curve 100 %. . The specificity was higher for the failed pregnancy and missed abortion was 96.7%, and 96.6%, while in ectopic pregnancy when we chose the cutoff point 29.55 was 100%. The precision was 98.36, 96.77, and100% for the failed pregnancy missed abortion and ectopic pregnancy respectively.
High interleukin -15 levels were associated with failed pregnancies, so these patients need to be closely follow interleukin -15 in diagnosis of ectopic and missed abortion.
References
1. Bohn JA. When Words Fail:“Miscarriage,” Referential Ambiguity, and Psychological Harm. The Journal of Medicine and Philosophy: A Forum for Bioethics and Philosophy of Medicine 2023;48(3):265-282.
2. Al-Najjar SG. Risk Factors of Missed Abortion in Thi-Qar City (Province of Iraq). Journal of Xi’an Shiyou University, Natural Science Edition 2022;18(7):256-70.
3. Askerov R. Embryoscopic diagnostics of endometrial defects in missed abortion after IVF. Gynecol Endocrinol 2016;32(suppl 2):62–3.
4. Chen M, Fan Z, Zhao F. Occurrence and maternal transfer of chlorinated bisphenol a and nonylphenol in pregnant women and their matching embryos. Environ Sci Technol 2016;50:970–7.
5. Wang X, Lee CL, Li RH, Vijayan M, Duan YG, Yeung WS, et al. Alteration of the immune cell profiles in the pathophysiology of tubal ectopic pregnancy. Am J Reprod Immunol. 2019;81(4):e13093.
6. Gencdal S, Aydogmus H, Gencdal NK, Destegul E, Ekmekci E. Evaluation of the neutrophil-lymphocyte ratio and plateletlymphocyte ratio in patients with ectopic pregnancies. J Clin Gynecol Obstet. 2019;8(3):81-4.
7. Ghafouri-Fard, S, Shoorei, H, Taheri, M. The role of microRNAs in ectopic pregnancy:A concise review. Non-coding RNA Res. 2020;5(2):67-70.
8. Hendriks E, Rosenberg R, Prine L. Ectopic pregnancy: diagnosis and management. American family physician. 2020 May 15;101(10):599-606.
9. Kadam VK, Agrawal S, Saxena P, Laul P. Predictive value of single serum progesterone level for viability in threatened miscarriage. The Journal of Obstetrics and Gynecology of India. 2019 Oct; 69:431-5.
10. Orefice R. Immunology and the immunological response in pregnancy. Best practice & research Clinical obstetrics & gynaecology. 2021 Oct 1;76:3-12.
11. Selvarajan S, Ramalingam J, Venugopal V. Soluble FMS-like tyrosine kinase-1: An overview. International Journal of Medical Biochemistry. 2023;6(2):1-18.
12. Hirota Y. Progesterone governs endometrial proliferation-differentiation switching and blastocyst implantation. Endocrine Journal. 2019;66(3):199-206.
13. Zhao Y, Zhang T, Guo X, Wong CK, Chen X, Chan YL, Wang CC, Laird S, Li TC. Successful implantation is associated with a transient increase in serum pro-inflammatory cytokine profile followed by a switch to anti-inflammatory cytokine profile prior to confirmation of pregnancy. Fertility and Sterility. 2021 Apr 1;115(4):1044-53.
14. Teirilä L, Heikkinen-Eloranta J, Kotimaa J, Meri S, Lokki AI. Regulation of the complement system and immunological tolerance in pregnancy. InSeminars in immunology Academic Press 2019; 45:101337.
15. Gordon SM. Interleukin-15 in outcomes of pregnancy. International Journal of Molecular Sciences. 2021 Oct 14;22(20):11094.
16. Alexandros Daponte, Efthimios Deligeoroglou, Spyros Pournaras, et al. Interleukin-15 (IL-15) and Anti-C1q Antibodies as Serum Biomarkers for Ectopic Pregnancy and Missed Abortion. Clinical and Developmental Immunology 2013: 1-6.
17. Gary Cunningham F., Kenneth J. Levendo, steven L. Bloom, Barbara L. Hoffman. Abortion. In: Williams obstetrics, 25th Edition, Mc Graw-Hill eduction, 2018;18; 347-54.
18. Gong G, Yin C, Huang Y, Yang Y, Hu T, Zhu Z, Shi X, Lin Y. A survey of influencing factors of missed abortion during the two-child peak period. Journal of Obstetrics and Gynaecology. 2021;41(6):977-80.
19. Jiang WZ, Yang XL, Luo JR. Risk factors for missed abortion: retrospective analysis of a single institution’s experience. Reproductive Biology and Endocrinology. 2022;20(1):115.
20. Fang J, Xie B, Chen B, et al. Biochemical clinical factors associated with missed abortion independent of maternal age: A retrospective study of 795 cases with missed abortion and 694 cases with normal pregnancy. Medicine (Baltimore). 2018; 97(50):e13573.
21. Yahya SA. Evaluation of ectopic pregnancy in Al-Salam Hospital in Mosul city. Iraq Medical Journal (IMJ). 2020;4(1): 23.
22. Attri S. Clinical Outcomes Associated with Ectopic Pregnancy. International Journal of Life Sciences, Biotechnology and Pharma Research 2023 ; 12(4):1450-55.
23. Muzaffar U, Rasool S, Ahmad K, Rasool M. Risk factors for ectopic pregnancy in women: A case control study. Infertility. 2020;22(2.9):0-01.
24. Daponte A, Deligeoroglou E, Pournaras S, Hadjichristodoulou C, Garas A, Anastasiadou F, Messinis IE. Interleukin-15 (IL-15) and anti-C1q antibodies as serum biomarkers for ectopic pregnancy and missed abortion. Journal of Immunology Research. 2013;2013:637513
25. Bülbül ZS. Can the Systemic Immune-Inflammation Index Be a Useful Marker for the Prediction of a Missed Abortion in the First Trimester of Pregnancy?. Dubai Med J 2023;6:14–19.
26. Kwak‐Kim J, Bao S, Lee SK, Kim JW, Gilman‐Sachs A. Immunological modes of pregnancy loss: inflammation, immune effectors, and stress. American journal of reproductive immunology. 2014;72(2):129-40.
27. Hadi C, Budiman J, Prasetyo A, Pramana C. The Role of Interleukin in Ectopic Pregnancy: A Systematic Review. Open Access Macedonian Journal of Medical Sciences. 2021;9(F):238-45.
28. Zhang Y, Zhao L, Wu A, Lin P, Fan J, Chen J, Wang X, Zeng X. Abnormal M1 polarization of placental macrophage induced by IL-15/STAT5 activation in VVC may lead to adverse pregnancy outcomes. Microbes and Infection. 2024;26(1-2):105232.
29. Saldanha CL, Ajaz S, Khan I, Bashir K, Qadri Q, Rasool R, Parvez T. Interleukin 15 as serum biomarker for ectopic pregnancy and missed abortion. The New Indian Journal of OBGYN 2023;9(2):344 - 48.
