Amniotic fluid prostanoid concentrations increase early during the course of spontaneous labor at term

Romero, Roberto; Baumann, P.; González, Rogelio; Gomez, Ricardo; Rittenhouse, Linda; Behnke, Ernesto; Mitchell, Murray D.

doi:10.1016/0002-9378(94)90412-x

Cited by 62 publications

(29 citation statements)

References 20 publications

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“…AF PG concentrations were measured using an enzyme-linked immunosorbent assay (ELISA) in this study. However, a radioimmunoassay (RIA), which was the method of choice for determination of PG in body fluids, was used in prior studies [7][8][9]20,21]. Although a difference in the study population would be a limitation in a direct comparison of PG concentrations between studies, ranges of AF PG concentrations in our data seem to be in accord with those of others.…”

Section: Strengths and Weakness Of This Studysupporting

confidence: 74%

“…However, some investigators have reported that the increase in PG concentrations is the consequence of labor rather than its cause since this increase becomes evident late in the course of labor [7]. This interpretation contradicts other studies in humans [8,9] and animals [4][5][6].…”

Section: Introductionmentioning

confidence: 86%

“…Several studies on AF PGs in the human have included data from women with pathologic conditions including rupture of membranes and fetal distress [7][8][9][20][21][22]. Therefore, the population did not represent physiology.…”

Section: Strengths and Weakness Of This Studymentioning

confidence: 99%

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Amniotic fluid prostaglandin concentrations increase before the onset of spontaneous labor at term

Lee

Romero

Park

et al. 2008

The Journal of Maternal-Fetal & Neonatal Medicine

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Objectives. The role of prostaglandins (PGs) in the onset of human parturition has been controversial. Specifically, some investigators have proposed that PGs are the consequence rather than the cause of labor. An important question is whether or not amniotic fluid (AF) PG concentrations increase before the onset of labor in humans. Methods. The concentrations of PGs were determined in AF obtained from 167 singleton pregnant women with intact membranes. Patients were divided into four groups: (1) preterm not in labor (gestational age 15-36 weeks, n ¼ 65); (2) term not in labor (n ¼ 68); (3) spontaneous labor at term with cervical dilatation 54 cm (n ¼ 25); (4) spontaneous labor at term with cervical dilatation 4 cm (n ¼ 9). AF was obtained by transabdominal amniocentesis or collected at the time of cesarean delivery. All patients met the following criteria: (1) normal pregnancy outcome; (2) clear AF; (3) no significant medical or obstetric complications such as diabetes mellitus, preeclampsia, preterm birth, fetal growth restriction, or major congenital malformations; and (4) no significant neonatal complications. The concentrations of PGE2 and PGF2a in AF were determined by enzyme-linked immunosorbent assay (ELISA). Non-parametric analysis was performed. Results. (1) AF PG concentrations remained unchanged with advancing gestation until 36 weeks of gestation; (2) however, an abrupt increase in AF PG concentrations was observed before the onset of labor at term; (3) among cases without labor at term, the median AF PGF2a concentration increased with advancing gestation; (4) the presence of labor and the degree of cervical dilatation were significantly associated with a higher concentration of PGF2a.Conclusions. An abrupt increase in AF PG concentrations (25-fold for PGF2a) occurs before the onset of spontaneous labor at term in humans; these observations suggest that PGs increase prior to the onset of labor and contradict the claim that an increase in PG concentrations is the consequence of labor.

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Section: Strengths and Weakness Of This Studysupporting

confidence: 74%

Section: Introductionmentioning

confidence: 86%

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Amniotic fluid prostaglandin concentrations increase before the onset of spontaneous labor at term

Lee

Romero

Park

et al. 2008

The Journal of Maternal-Fetal & Neonatal Medicine

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“…3 Labour initiation is considered to be brought about by a shift in the balance from signals causing uterine relaxation to those signalling uterine contraction. Factors that have been shown to potentially play a role in the initiation and progression of labour, include an alteration in the estrogen to progesterone ratio, 4 functional progesterone withdrawal in the myometrium through a change in progesterone receptor A:B isoform ratio, 5 modulation in the levels of prostaglandins [6][7][8][9][10] and of their receptors, and an increase in oxytocin levels, 11,12 and oxytocin receptor sensitivity, 13 increased levels of corticotrophin-releasing hormone (CRH), 14,15 inflammatory mediators, 16,17 and myometrial distension/stretch. 18 More recently, evidence has emerged that suggests a role for the endocannabinoid system in labour.…”

Section: Introductionmentioning

confidence: 99%

The plasma levels of the endocannabinoid, anandamide, increase with the induction of labour

Nallendran

Lam

Marczylo

et al. 2010

BJOG

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Objective Plasma anandamide (AEA) levels have previously been shown to be elevated in labour and defective cannabinoid receptor type 1 signalling in mice has been shown to be associated with elevation of corticotrophin-releasing hormone and spontaneous onset of preterm labour. We measured plasma AEA levels in women undergoing induction of labour to define the changes during the transition from the nonlabouring to labouring state.Design A longitudinal observational study.Setting A large UK teaching hospital.Population Term pregnant women undergoing induction of labour.Methods Blood was collected from women before induction of labour and again when they were in active labour. Plasma AEA was extracted and measured using ultraperformance liquid chromatography-tandem mass spectrometry.Main outcome measures The primary outcome variable was change in plasma AEA levels from the nonlabouring to the labouring state. The secondary outcome was induction-to-delivery interval.Results There was a 1.5-fold increase in mean plasma AEA levels from 1.20 ± 0.57 nm in the nonlabouring state to 1.82 ± 0.87 nm in the labouring state (P < 0.0001). Induction-to-delivery interval was predicted by both Bishop's score (P < 0.0001) and percentage change in plasma AEA levels (P < 0.0001). There was a negative correlation between the percentage change in plasma AEA level and the induction-to-delivery interval (r = -0.28; P = 0.0481). This means that the greater the rise in the plasma AEA levels the shorter the duration of labour.Conclusions Plasma AEA levels increase with active labour and the negative correlations between percentage change in plasma AEA levels and induction-to-delivery interval suggest that AEA is likely to be involved in the physiological mechanisms of labour. Whether this increase is essential for myometrial contraction is unclear and needs further investigation.

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“…In the undeveloped part of the world the major couses of the preterm deliveres are infections, malnutrition and poor antenatal care, while in developed countries major couses are methods of assisted reproductions and earlier completition of vunerable pregnancies (3). According to the latest researches of preterm delivery is a syndrome caused by many causes, knowledge of these causes would improve the prevention and treatment of preterm delivery (4). Behr et al, (5) causes of preterm delivery are divided to: fetal, placental, uterine, maternal and other causes.…”

Section: Introductionmentioning

confidence: 99%

Etiological factors of preterm delivery

Brkičević¹,

Grgić

Ljuca

et al. 2013

JHSCI

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Introduction: Preterm delivery is the delivery before 37 weeks of gestation are completed. Preterm birth is a major course of neonatal morbidity and mortality, the incidence of premature delivery in developed countries is 5 to 9%. Aims of this study were to determine the common etiological factors for preterm delivery, most common weeks of gestation for pretern delivery, and most commom way of delivery for preterm delivery. Methods:The study included 600 patients divided into two groups, experimental group (included 300 preterm delivered pregnant women), control group (included 300 term delivered women). Results:The incidence of preterm delivery in pregnant women younger than 18 years was 4.4%, and in pregnant women older than 35 years was 14%. 44.6 % of preterm delivered women at the experimental group had lower education. In the experimental group burdened obstetrical history had 29%, 17.2% had a preterm delivery, 35.6% had a premature rupture of membranes, 15% had a preterm delivery before 32 weeks of gestation, 12.4% between 32-33.6 weeks of gestation, while 72.6% of deliveries were between 34-36.6 weeks of gestation. Multiple pregnancy as an etiological factor was present in 10.07% of cases. Extragenital diseases were present in 10.4%. In the experimental group there were 29%, while in the control group there were 15% subjects with burdened obstetrical history. Conclusions:Preterm birth more often occurs in a pregnant women younger than 18 and older than 35 years, and in a pregnant women of lower educational degree. Preterm delivery in the most common cases was fi nished in period from 34 to 36.6 weeks of gestation. The most common etiological factor of preterm delivery in the experimental group was preterm rupture of membranes and idiopathic preterm delivery.

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Amniotic fluid prostanoid concentrations increase early during the course of spontaneous labor at term

Cited by 62 publications

References 20 publications

Amniotic fluid prostaglandin concentrations increase before the onset of spontaneous labor at term

Amniotic fluid prostaglandin concentrations increase before the onset of spontaneous labor at term

The plasma levels of the endocannabinoid, anandamide, increase with the induction of labour

Etiological factors of preterm delivery

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