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Preoperative Amniotic Fluid Interleukin-6 Levels as Predictors of Adverse Perinatal Outcomes Following Fetal Laser Surgery for Monochorionic Twin Complications.

Created on 21 Oct 2025

Authors

Petra Hanulikova, Lubomir Haslik, Ladislav Krofta, Anna Brandejsova, Alexandra Regendova, Daniela Vankova, Matus Halaj

Published in

Fetal diagnosis and therapy. Pages 1-22. Oct 20, 2025. Epub Oct 20, 2025.

Abstract

This study aimed to assess whether levels of interleukin 6 (IL-6) in amniotic fluid (AF) can predict perinatal complications following fetal laser surgery in monochorionic twins with twin-to-twin transfusion syndrome (TTTS).
We conducted a retrospective cohort study at the Fetal Medicine Center from 2013 to 2024, analyzing AF samples from 152 monochorionic twin pregnancies before surgery. Cut-off levels for IL-6 were set at 400 ng/l and 2000 ng/l based on a 10% false positive and negative rate.
Among the 152 women who underwent laser surgery, significant associations were found between AF IL-6 levels and pregnancy duration in TTTS cases (p = 0.005); in cases complicated by selective growth restriction (sFGR), no significant association was found (p = 0.584). 112 TTTS pregnancies were categorized into 3 groups according to IL-6 levels. The overall prevalence of short surgery - delivery - interval (<14 days) was 11.6% (13/112), 1.9% in the low-risk group and 21.4% in the high-risk group (OR 13.9, p=0.028). The risk of preterm birth (≤28 weeks) was also higher in the high-risk group (50% vs. 9.6%, OR 9.4, p = 0.002), and adverse neonatal outcomes were more prevalent (63.6% vs. 20%, OR 7.0, p = 0.007).
AF IL-6 levels are a reliable marker for predicting adverse perinatal outcomes after fetal laser surgery, showing a high negative predictive value.

PMID:
41115097
Bibliographic data and abstract were imported from PubMed on 21 Oct 2025.

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