Maternal serum progesterone, estradiol and estriol levels in successful dinoprostone-induced labor

Abstract

Hormone-mediated quiescence involves the maintenance of a decreased inflammatory responsiveness. However, no study has investigated whether labor induction with prostanoids is associated with changes in the levels of maternal serum hormones. The objective of this study was to determine whether labor induction with dinoprostone is associated with changes in maternal serum progesterone, estradiol, and estriol levels. Blood samples were obtained from 81 pregnant women at term. Sixteen patients had vaginal birth after spontaneous labor, 12 required cesarean section after spontaneous labor and 16 underwent elective cesarean. Thirty-seven patients had labor induction with dinoprostone. Eligible patients received a vaginal insert of dinoprostone (10 mg) and were followed until delivery. Serum progesterone (P4), estradiol (E2) and estriol (E3) levels and changes in P4/E2, P4/E3 and E3/E2 ratios were monitored from admission to immediately before birth, and the association of these measures with the resulting clinical classification outcome (route of delivery and induction responsiveness) was assessed. Progesterone levels decreased from admission to birth in patients who underwent successful labor induction with dinoprostone [vaginal and cesarean birth after induced labor: 23% (P < 0.001) and 18% (P < 0.025) decrease, respectively], but not in those whose induction failed (6.4% decrease, P > 0.05). Estriol and estradiol levels, P4/E2, P4/E3 and E3/E2 ratios did not differ between groups. Successful dinoprostone-induced labor was associated with reduced maternal progesterone levels from induction to birth. While a causal relationship between progesterone decrease and effective dinoprostone-induced labor cannot be established, it is tempting to propose that dinoprostone may contribute to progesterone withdrawal and favor labor induction in humans.

Parturition dysfunction in obesity: time to target the pathobiology

“…Chronically elevated PGE 2 in late pregnancy among obese women with meta-inflammation could decrease the sensitivity of maternal tissues to PGE 2 during labor activation, a finding that has been documented clinically [ 104 ] and is supported by the known elevated PGE 2 in obesity [ 105 , 106 ]. Insensitivity to PGE 2 during labor induction is linked to failed functional progesterone withdrawal [ 107 ]. Thus, the chronic inflammatory state of obese women could impede functional progesterone withdrawal and PGE 2 activation.…”

Disrupting the circadian photo-period alters the release of follicle-stimulating hormone, luteinizing hormone, progesterone, and estradiol in maternal and fetal sheep

“…In both pregnant women and sheep, plasma estradiol concentrations increase significantly, peaking during late pregnancy [15, 16, 29]. In late pregnancy, estradiol may promote uterine blood flow, stimulate cervical softening at term, and be essential for initiation of labor [19,20,21]. Estradiol also plays an important role in regulating fetal ovarian development in baboons [30].…”

“…Plasma concentrations of progesterone increase abruptly in the early weeks of pregnancy and remain at high levels throughout pregnancy [15, 16, 29]. Recent studies have suggested that a reduction in progesterone is critical for the initiation of labor [21, 22]. Progesterone also plays an important role in regulating fetal development [31].…”

“…Studies on baboons and humans have demonstrated that estradiol also promotes uterine blood flow, cervical softening at term and that it is essential for initiating labor in the third trimester of pregnancy [19, 20]. In addition, studies on pregnant women have indicated that a decrease in progesterone levels is critical for the initiation of labor [21, 22]. Together, the pulsatile secretion of these reproductive hormones seems to play an important role in pregnancy.…”

Antibody Response to Pertussis Vaccination in Pregnant and Non-Pregnant Women—The Role of Sex Hormones

“…In pregnant women, hormone levels were not measured at the time of vaccination, but 45-60 days after. Since serum estrogen and progesterone levels remain high until the end of the third trimester of pregnancy [20][21][22][23] and change only after delivery [24,25], the hormone levels measured immediately before delivery should be representative of the hormone levels at the time of immunization. As regards the anti-PT immunological memory in the study population, due to previous exposure or immunization, there does not appear to be any reason to believe that the extent of immunological memory in pregnant and non-pregnant groups will be different.…”