Such a finding may enhance the negative and/or the positive predictive value of a chemical biomarker. Previous study demonstrated that sonographic measurement of fetal membrane thickness could be helpful in the prediction of preterm delivery.[16] Using the amniotic fluid and cervical length data from the randomized trials noted above, we examined the relationship

between cervical length and levels of inflammatory mediators in amniotic fluid.[17] Pembrolizumab Spearman correlations were used to determine which cytokines correlate with cervical length. Stepwise regression identified the most significant cytokine predictive of early delivery, and a ROC curve determined the cervical length cutoff predictive of intra-amniotic inflammation. Our results indicate that cervical length ≤5 mm is associated with significant

increases in amniotic fluid inflammatory cytokines, even in the absence of infection or labor. A cervical length of ≤5 mm was associated with significant increases in inflammatory mediators (Interleukin (IL)-1β, IL-2, IL-6, IL-8, and MCP-1), which have been previously shown to be associated with preterm labor.[18, 19] Unfortunately, the dataset was too small to allow a multivariable analysis including both cervical length and mediator levels in predicting outcome. While a very short cervical length is a good indicator of intrauterine inflammation, it represents the final common pathway of multiple inciting events that can result in preterm labor. As Quizartinib ic50 such, it is not an ideal biomarker when utilized alone. Many of these patients will go on to delivery prematurely despite intervention. It is likely that markers which identify earlier in-utero events will allow more effective therapies Cytidine deaminase to be designed to stop the preterm labor cascade before the cervix becomes shortened. It appears that the intrauterine compartments are mostly immunologically distinct, and the expression of inflammatory markers in various maternal-fetal compartments will

be differentially expressed in non-invasive sampling sites. Because the etiology of preterm labor is multifactorial, using multiple biomarkers from distinct biologic pathways will better predict the risk of preterm labor. Furthermore, combining non-invasive tools such as a physical or ultrasound finding physical finding may improve the ability of specific biomarker in predicting outcome. Platforms to measure for example the levels of inflammatory mediator are commercially available and can easily be incorporated into ongoing trials looking at interventions to treat preterm labor. Initially, data can be collected in an observational manner and correlated with outcomes.